Inspection on 15/07/08 for High Street (196)

This inspection was carried out on 15th July 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

High Street (196) 19/07/06

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

Extracts from inspection reports are licensed from CQC, this page was updated on 09/02/2009.

CARE HOME ADULTS 18-65 High Street (196) 196 High Street Rickmansworth Hertfordshire WD3 1BD Lead Inspector Marian Byrne Unannounced Inspection 15th July 2008 09:00 High Street (196) DS0000067371.V369072.R02.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 High Street (196) DS0000067371.V369072.R02.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. High Street (196) DS0000067371.V369072.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service High Street (196) Address 196 High Street Rickmansworth Hertfordshire WD3 1BD 01923 774869 01923 771670 keithparkes@tiscali.co.uk www.caretech-uk.com CareTech Community Services Ltd 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) Keith Parkes Care Home 12 Category(ies) of Learning disability (12), Mental disorder, registration, with number excluding learning disability or dementia (5), of places Physical disability (7) High Street (196) DS0000067371.V369072.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th July 2006 Brief Description of the Service: 196 High Street is a 12-bedded home. It has been renovated from an original 22-bedded older person home. The home is in a residential area of a small bustling town and is located ideally to meet the needs of the service users, with amenities located within a short walking distance. The property benefits from being located within spacious grounds with landscape gardens designed to provide privacy for the service users and accessible flowerbeds, which will empower and enable service users to participate if desired. The 12-bedded home operates as two separate units with the ground floor supporting 7 persons with associated physical disabilities and the first floor supporting 5 more able people with associated behavioural issues that may challenge. All bedrooms have en-suite facilities with walk in shower areas. Suitable private lockable storage is provided in each room. Each bedroom exceeds the minimum measurements and presents extremely well with a number of bedrooms having exits straight into the private garden area. Each floor also has a lounge, dinning room, kitchen, and activity room, separate laundry with equipment as required to meet individual needs. All bathrooms and toilets are equipped to meet individual needs with aids and equipment. In addition to individual space and bathrooms there are additional bathing facilities that provide 2 bathrooms with ample space. Specialist Parker and Bagheera systems are provided including shower attachments and overhead tracking in the ground floor bathroom. There is a lift and staircase to the first floor with suitable fire exits throughout the building. Information regarding the service is available in the Statement of Purpose and Service User Guide. These and a copy of the most recent CSCI inspection report are available on request from the manager. For details of the most up to date fees please contact the service directly. High Street (196) DS0000067371.V369072.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. One inspector carried out this inspection over a period that covered late morning and early evening. Most of the inspection was completed in the downstairs of the home where the people who have the most profound disabilities live. Interaction was observed between staff and the people who use the service. Surveys were sent out to the residents and their families. However, we had a low number returned. Appropriate records were examined during the site visit to evidence that people’s needs were being safely met by the service. The Annual Quality Assurance Assessment (AQAA) provided by the service was received in time for this inspection and has been examined. This is a self assessment document that focuses on outcomes for service users and also provides us with some statistical data. What the service does well: The staff are very caring and staff told us that some of them work extra time at their own expense to ensure that there is a full handover to the next shift so that information to enable continuity of care is provided for the people who use the service. The home report that is working closely with the family whose relative has moved into residential care for the first time. The training of the permanent staff is very good, and staff are appropriately recruited to ensure that vulnerable people are protected. All security and identity checks had been carried out which includes a Criminal Records Bureau clearance. The residents who live on the top floor of the home have a good living experience, as they are more independent. High Street (196) DS0000067371.V369072.R02.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: The high number of young people who have profound learning difficulties living together poses challenges for staff. People who live in the home are not necessarily having all their needs met and various examples are given throughout the report. Staff used to have time built into the day to do a detailed handover to the next shift but this has been changed to a paper handover that staff report is little more than a tick sheet. This may be sufficient for the people who live on the top floor who are more independent but is not detailed enough to meet the very high needs of the young people who live on the ground floor. Some staff reported to us that they stay to do a personal handover in their own time. The approach to handovers must be consistent and for the benefit of the people who live there. The meal time we observed downstairs was found not to be very homely and served in a haphazard manner. Staff do not set the tables and sit down with the residents to their evening meal in a homely manner. The young people were not served together and one person’s meal was left on the side and was given to them when the staff were able to as they passed by. Some individual good practice was noted with one resident. The managing of staffing numbers was difficult to follow and understand. On days the people go to college fewer staff are on duty. It is the task of the night staff to assist two residents to get up and ready for their day at college. These dedicated tasks mean that the night staff are not available to the other five residents on the ground floor who are very frail and have very high needs. Some staff work very long hours working over 14 hours per day and then have a journey home that involves travelling into central London and working 6 days some weeks. It is important that staff are fresh and alert enough to provide good quality care to the people that receive a service and that this is monitored by the manager. As some of the residents are very young and have recently left home for the first time their families are closely involved in some of their care but some staff have indicated that those residents who do not have robust family representatives may get overlooked especially in the activities field. Those families who responded to our survey indicated that they are generally happy with the care of their relative but all who responded were unhappy with the amount of activity outside the home for their relative. On the ground floor the High Street (196) DS0000067371.V369072.R02.S.doc Version 5.2 Page 7 ratios of staff to residents needs to be reviewed to ensure that the young people have optimum life opportunities. 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. High Street (196) DS0000067371.V369072.R02.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection High Street (196) DS0000067371.V369072.R02.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people who use the service can be sure their needs and aspirations are assessed to ensure plans of care are drawn up that meet their identified needs. EVIDENCE: People who are admitted to the home have a full assessment. However, none of the younger resident were admitted with their life history, this should have been written up by the professionals who were responsible for their care and their referral to the home. It was subsequently reported to us that this information was repeatedly requested by the service but to no avail. This has made life difficult for the staff who now deliver their care. However, it must be noted that the staff have worked hard with families and representatives to gather all available information. High Street (196) DS0000067371.V369072.R02.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 and 9. 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 can be assured that most of the residents have their goals recognised however, they are not always realised and met. EVIDENCE: We looked at care plans of two residents while sitting in the sitting room with them. The care plans contained good information on the two residents. One care plan listed what a resident does when they are distressed, stating ‘I have a life long habit of putting my fingers of my left hand in my mouth continuously. This can cause my fingers, mouth and cheek to become sore. If I have something to interest me and to play with this prevents me from putting my fingers in my mouth’. We saw that the resident was displaying all the signs of being distressed. They were turned away from the television and left facing us. However, we saw that they were unable to access anything to play with or to interest them. We were initially unable to understand their High Street (196) DS0000067371.V369072.R02.S.doc Version 5.2 Page 11 distress until we came to the part of the care plan that explained their actions. A staff member came in and took the person away and when the resident returned later, their clothes had been changed and they were placed on the floor where they had access to their things and no longer showed signs of distress. The care plans are currently under review and are being re-written in a more person centred manner. Some staff have received training on this. The care plans give good information on all aspects of the residents, they highlight problems that the residents may encounter and provide staff with the information on how recognise patterns of behaviour, what it means and how to meet the individual needs. A good example of this was: a resident was eating their evening meal outside the kitchen in the hallway. They were using a chair with a red cushion on it as a table. This cushion is special to the person and it is the only way that they are comfortable eating and this is highlighted in their care plan. When the person moved into the home they would only eat in their room. Other examples are given throughout the report. Staff are aware of the need to promote the independence of the residents, this is done through thorough risk assessments that highlight risks and identify what can be done to reduce them to ensure all foreseeable risks are identified and plans put in place around them. Staff are dedicated to promoting the independence of the residents and work closely with families to ensure that the residents have as much independence as possible. The only barrier to this is the staffing numbers - this is explored later in the report. High Street (196) DS0000067371.V369072.R02.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): 12,13,15,16 and 17. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Some of the people who live in this home do not have the opportunities for personal development especially within their social lives. People cannot be assured that mealtimes provide a pleasurable experience for all the residents who live in the home. EVIDENCE: On the day of the inspection we saw that there was one member of staff attending to four residents who have profound learning difficulties downstairs. The seven young residents downstairs all need a wheelchair at some point and need two staff to attend to some of their needs. It was explained that there were interviews being held on that day and extra staff had not being brought in to assist residents while one staff member and the manager were involved in the interviews. We were informed subsequent to the inspection that extra High Street (196) DS0000067371.V369072.R02.S.doc Version 5.2 Page 13 staffing was not requested as the interviews lasted only one and a half hours and staff could have been called from upstairs. However, it should be noted that the inspector rang the doorbell three times before gaining access. There were two residents in the downstairs sitting room and the television was on showing a programme where people bought holiday homes abroad. Neither of the residents were looking at it. The social diary for June 2008 was as follows: Whipsnade 2nd June, Train to London 6th June, Watching Sailing 7th June, Village Fair 7th June, High Street 9th June, Outing to Aquadrome 14th June, Swimming 27th June, Walk 28th June and Stroll 28th June. This lists just 8 days in June where activities were recorded. Surveys we received stated that the families were not happy with the amount and quality of activities that the residents had. The manager was clear that the home did not have enough staff who drive to take the residents out. However, it must be noted that a driver interviewed on the day of the inspection was offered the post. We saw that not all the residents currently have their emotional needs met an example of this was a resident who is totally blind and has very sensitive hearing. Staff reported to us that this person finds loud noises distressing. Their room is next door to a resident who because of their profound learning disability likes to play music very loud. This causes distress to the other resident. The night staff have to get some residents up ready for the morning for a 08:15 bus pick up for college. It is not possible to say if the residents who are got up by night staff have been offered a choice in the times they get up as this is limited by staff numbers and the need to be ready for the college bus. The residents who live on the top floor are more independent and have a different living experience to those on the ground floor. Residents on the top floor who spoke with told us that they were very happy with how their needs were met. One resident showed us around the top floor and was very complementary of how they were supported to live a full life. Two of the top floor residents were out for a meal on the evening of the inspection; therefore we did not get the opportunity to see them. We saw that the staff on duty on the day of the inspection were very busy and appeared to be very dedicated to the residents. The outcomes for the more profoundly disabled would indicate that there are not enough staff to duty to ensure the residents live full lives where their aspirations are recognised and met. This is explored further under staffing later in this report. Most of the 7 young people on the ground floor need assistance with eating. One is able to feed themselves, one likes to eat away from the dining room under supervision and the other five needed assistance. Mealtime was not High Street (196) DS0000067371.V369072.R02.S.doc Version 5.2 Page 14 leisurely or homely, tables are not set for people’s meals but staff bring the meals out already plated. This offers people no choice or the opportunity to gain independence. We saw that the residents were given a meal and in some instances assisted to eat by staff who did not always sit with them but stood over them to provide assistance. One resident was left in the sitting room. One resident has no vision but when they were in the dining room at mealtime they were left unattended as the staff (who were very busy) were assisting other residents with their meal. This person’s meal had been served and set to one side; one staff member gave them a spoonful as they passed by. The resident sat quietly and waited to be assisted. We also saw that this person was not included in any of the conversation in the room. High Street (196) DS0000067371.V369072.R02.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Some of the residents can be assured that their emotional health and physical needs will be met in a manner they choose. The administration of medication was in order ensuring the optimum health, welfare and safety of the residents. EVIDENCE: Evidence presented in the Annual Quality Assurance Assessment (AQAA provided by the service) indicates that nine of the residents need assistance with washing, 12 with bathing, 9 need assistance using the lavatory, 7 are doubly incontinent and 8 need assistance with meals. This shows us that the residents have high needs and most need staff with them at all times. One resident needs one to one care when they are in their room. This leaves three staff to assist the other six residents on the ground floor, all of who need the assistance of two staff members to conduct some aspects of their lives. There is no doubting the dedication of the permanent staff who work in the home. However the staffing levels need to be reviewed to ensure all of the residents have the healthcare and personal support that their needs demand. The High Street (196) DS0000067371.V369072.R02.S.doc Version 5.2 Page 16 personal support observed at times throughout the inspection was not always provided in a way that respected people’s dignity and rights. This is explored throughout this report please see sections on Individual Needs and Choices and Lifestyle sections for comments. The storage and administration of medication was found to be in order to ensure that people are kept safe and have optimum health. High Street (196) DS0000067371.V369072.R02.S.doc Version 5.2 Page 17 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 and 23. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Most of the people who live in this service can be sure that their concerns will be understood and responded to. Staff are aware of the procedures for safeguarding vulnerable people but the staffing levels may leave people at risk. EVIDENCE: In the past year the home has had 8 complaints. The organisation has investigated these, four were upheld and the investigation of two has yet to be completed. Staff were aware of whistle blowing and safeguarding adults procedure, which helps ensure people are aware of the procedures to follow if they see or suspect abuse. However, the staffing levels on the ground floor and the current handover procedure may cause unintentional neglect to some of the residents - particularly those who cannot make their needs easily known. Staff reported that they were concerned that adequate information was not made easily available to them so to enable them to meet the care of the residents. Additionally the very long hours worked by some staff and the lack of a formal adequate handover may inadvertently lead to staff not being able to meet the current needs of the residents. The manager must ensure that the Working Time Regulations are met and that staff are monitored to ensure that they are fit for duty. High Street (196) DS0000067371.V369072.R02.S.doc Version 5.2 Page 18 Daily notes seen indicated that one person had a specific negative behaviour when distressed. We saw no evidence that this had been followed up or that risk assessments had been completed. Other examples where service users are not always protected have been included in the report (see Lifestyle and Personal and Healthcare Support sections). High Street (196) DS0000067371.V369072.R02.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. All the residents can be sure that the home is comfortable and safe, and clean and hygienic to meet their needs. EVIDENCE: All the residents have their own rooms that are personalised and meets their needs. Two rooms in the home do not have windows – they have a glass door that opens onto the garden. However, the home have recognised that this is not sufficient to meet the needs of the two young people who live there and have made plans to have windows put in. With the exception of some carpets the home was clean and fresh on the day of the inspection. The carpet was stained the manager assured us that they were about to clean this. High Street (196) DS0000067371.V369072.R02.S.doc Version 5.2 Page 20 The garden was well tended to and well suited to the high needs of the residents. We saw that it was not being used on the day of the inspection despite the day being sunny and warm. High Street (196) DS0000067371.V369072.R02.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34 and 35. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Some of the people who live here cannot expect the current staffing levels to support their identified needs or expectations. EVIDENCE: We found the staff on duty to be both dedicated and have a good knowledge of the needs of the residents. The recruitment and training of staff is very good and ensures vulnerable people are protected. All the appropriate security and identity checks had been carried out; this includes a Criminal Records Bureau clearance. Staff are well trained but the staffing ratios and the long hours worked by some staff impede the outcomes for the residents. This has led to some of the care being carried out in a task-oriented manner, which we saw was particularly true of the evening meal (see Lifestyle section for comments). The needs of the residents were recognised as stated earlier in the report but these needs were not always met. As already reported an example of this was one resident who has profound disabilities, staff have discovered that their hearing is extremely sensitive and that they find loud noises difficult. Their room is next to a resident who through their own needs finds comfort from High Street (196) DS0000067371.V369072.R02.S.doc Version 5.2 Page 22 having their music played very loudly. On the day of the inspection we saw the resident lying curled on their bed, their door was open and the music coming from the other person’s room was very loud. Some staff work very long shifts and then have long journeys home. Some of the shifts were 14 hours a day followed by another long day with a recent rota showing staff working 72 hours per week. The 14-hour day was followed by an early morning shift not allowing an adequate break for the staff member. This is against the European Work Time Directive. There was no formal risk assessment in place to show that the manager knew that a member of staff (no matter how dedicated) could safely meet the resident’s needs while working such long hours. As well as meeting the very high needs of some of the residents the staff have to cook all meals, clean the home and ensure residents have clean clothes. We have since the inspection been informed that residents are encouraged to be part of all aspects of the running of the home including cleaning and cooking. High Street (196) DS0000067371.V369072.R02.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): 37,39 and 42. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The current staffing levels and deployment of staff may mean that the home is not being run in the residents best interests to ensure that their needs are appropriately met at all times. EVIDENCE: The AQAA was returned when we requested it. We found the Registered Manger to be dedicated to the welfare of the residents. He was fully aware of their needs and the need to get more permanent staff in the home. However we found that the home is not always managed in the best interest of the residents and examples of this have been given earlier in the report. Person centred planning has yet to be fully introduced although it is acknowledged that this has started. Handovers (particularly on the ground floor) have been changed to a paper exercise this means that when staff are busy they may not High Street (196) DS0000067371.V369072.R02.S.doc Version 5.2 Page 24 always have the time to access the appropriate paperwork to obtain the information and it does not offer other staff the opportunities to ask questions. Staff spoken with were not happy with this arrangement and felt that they did not get enough information to promote the welfare of the residents. The manager must be confident that appropriate information is exchanged, as it is important to the welfare of the residents. The staffing levels are reduced by one when two residents are attending college. The night staff have to ensure two of the most profoundly disabled residents on the ground floor are assisted to get up washed and dressed on college days. This takes them away from meeting the needs of the other five residents on the ground floor who also have profound learning disabilities. We were told that it takes two staff between 30 and 50 minutes to get one person ready and the second resident may need one or two staff depending on how they are on the day, which takes between another 30 and 40 minutes. This could take two members of staff away from the care of the other residents for up to ninety minutes, which could put all the ground floor residents at risk. Every effort is made to ensure that the views of the residents and their families and representatives are sought. However, the families who responded to our surveys stated that the residents did not get taken out of the home enough for activities. Although we are aware that the manager has made every effort to address these issues a resolution must be found urgently that meets peoples’ needs and expectations. With the exception of the staffing levels we saw that the health and safety of the residents was promoted. There is a fire plan in place and all equipment used in the home is well maintained. The manager of the home must ensure that all employment laws are adhered to and must be sure that the staff on duty are physically and mentally fit and can therefore meet the needs of the residents and provide good quality care. High Street (196) DS0000067371.V369072.R02.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 2 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 2 33 X 34 2 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 2 X 2 X LIFESTYLES Standard No Score 11 X 12 2 13 2 14 X 15 2 16 2 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 2 3 x 2 X 2 X X 2 X x High Street (196) DS0000067371.V369072.R02.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA33 Regulation 18(1)(a) Requirement The responsible individual must ensure that there are sufficient numbers of staff on duty who are trained to meet the needs of the residents as set out in this report. This includes ensuring that meals are eaten in a peaceful and homely environment. 2 YA18 12 (1)(b) The resident identified as X in this report who has very sensitive hearing must be reviewed to ensure that their needs are met. 31/08/08 Timescale for action 31/08/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations High Street (196) DS0000067371.V369072.R02.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 High Street (196) DS0000067371.V369072.R02.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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