Inspection on 17/05/07 for High View Residential Unit

This inspection was carried out on 17th May 2007.

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

The inspector found 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 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

High View Residential Unit 30/01/08

High View Residential Unit 13/12/06

Similar services:

Ashlong House

Norbury Crescent (30)

Agar Grove & St Augustine`s Alcohol Treatment & Rehab

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

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

CARE HOME ADULTS 18-65 High View Residential Unit 84 Thurlow Park Road Dulwich London SE21 8HY Lead Inspector Ann Wiseman Unannounced Inspection 17th May 2007 12:30 DS0000066673.V339823.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 DS0000066673.V339823.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. DS0000066673.V339823.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service High View Residential Unit Address 84 Thurlow Park Road Dulwich London SE21 8HY 0208 670 0168 0845 331 2725 staffview@yahoo.co.uk 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) High View Care Services Ltd Care Home 7 Category(ies) of Past or present alcohol dependence (0), Past or registration, with number present drug dependence (0), Dementia (0), of places Learning disability (0) DS0000066673.V339823.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13th December 2006 Brief Description of the Service: Highview is registered to accommodate service users between the ages of 18 to 65 who have been assessed as having alcohol and drug related problems, dementia resulting from alcohol and drug misuse, challenging behaviour due to substance misuse, learning disabilities or acquired brain injury. Accommodation is spread over three floors. Service users benefit from large bedrooms with en suite facilities. There are additional bath and shower facilities as well as kitchen and laundry facilities. There is a well-maintained garden to the rear of the property. There is limited off-road car parking to the front of the building; however the home benefits from being close to bus and train links. The home is within walking distance of other public amenities. DS0000066673.V339823.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Inspection included a visit to the home that lasted five hours; the Operations Manager, who has been acting Manager since the previous Manger left in May, facilitated the visit. The Inspector also had the opportunity to talk with four of the Residents, a family member, several of the staff members and representatives of the placing authorities. The Pre Inspection Questionnaire sent to providers prior to an Inspection was not returned to the commission. Since the home opened late 2006 the Registered Provider, who managed the home then, has stepped back from direct management and the person who was appointed as acting manager has since left, then the companies Operations Manager took up post as Acting Manager in May. So High View has not had consistent management for most of its history. Since the Inspection the Operations Manager has taken up the post of Manager and will be applying for Registration. There are some outstanding Requirements from the previous Inspection. A questionnaire was sent to the Residents by the Commission, most of them were helped to complete the form by staff and on the whole the Residents feel that High View is a good place to live and that the staff treat them well and know what they need and help them to be independent and to make choices for themselves. Staff believe that they are doing a good job but feel let down and unsupported by not having a permanent Manager in position. They were just getting to know the previous acting Manager before he left and now have the uncertainty of getting to know someone else. Other professionals have voiced concerns about the management of the home and are beginning to wonder if High View is best suited to the people they act on the behalf of. It is the Inspectors opinion that failure to have an experienced Registered Manager in place has had a detrimental effect on the home and to the care and development of the people living in it. Once the new Manager has settled into his job and has developed his knowledge of the Regulations under the Care Standards Act 2000 and it’s related Regulations and National Minimum Standards it is hoped that this service will become a good and stable place to live; there is already a strong and experienced staff team in place who are well qualified to work with this client group. What the service does well: DS0000066673.V339823.R01.S.doc Version 5.2 Page 6 High View offers a comfortable place to live with a homely atmosphere. It is well decorated and has an attractive garden with an inviting summerhouse that offers a quiet refuge. Staff are committed to offering a good quality of service and are knowledgeable of the needs of the Residents. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. DS0000066673.V339823.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 DS0000066673.V339823.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): All of these standards were examined during this visit. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective Residents and their representatives are provided with information about the service prior to admission. Needs and aspirations are assessed and people moving in are assured that the home can meet their needs and are given contracts that include the statement of terms and conditions. EVIDENCE: There is a comprehensive Statement of Purpose and a Users Guide detailing information regarding the care and service provided and both parties’ rights and responsibilities. Both these documents contain copies of the home’s complaints procedure. The initial assessment was examined for two of the people living in the home. Information had been provided by service users’ social workers and the manager had also completed an assessment at the time of meeting prospective Residents. Staff confirmed that following the pre admission assessment, a letter is sent to prospective Residents confirming that following the assessment the home can meet their needs. DS0000066673.V339823.R01.S.doc Version 5.2 Page 9 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): All f these standards have been examined during this Inspection. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Care plans are in place and have been updated and restyled since the last Inspection. People living in the home are able to make decisions about their lives, are consulted and are able to participate in all aspects in the home. Concerns have been raised that the home is not following guidelines put in place to protect Residents wellbeing. Information is handled appropriately. EVIDENCE: Two Residents files were examined and each contained Care Plans that carried quite detailed information about each person’s history and how to meet their needs. One of the Care Plans had been reviewed in March 07 and the other was reviewed in April 07. A monthly review was seen that drew together information of the last month’s events such as medical appointments, their outcomes and daily activities. This summery was dated and signed by both the staff member completing the review and the Resident. DS0000066673.V339823.R01.S.doc Version 5.2 Page 10 Interventions to stop one Resident leaving the building have been put in place to safeguard his well being, they were instigated only after a multidisciplinary meeting that was attended by the Resident who signed the agreement. It was good to see comprehensive recording in people’s daily logs, with information recorded regarding their health and general demeanour. Risk assessments had been completed in relation to Residents; these promoted independence whilst minimising risk and potential harm to service users. It was apparent from interaction between staff and service users, and from records seen, that the Residents are included in the discussion making processes within the home. However placing authorities have expressed concerns about the level of supervision given to the Residents and the Staff not following guidelines; People who have been assessed as needing supervision while out of the house have been able to go out alone. Considering the client group supported by this home, the importance of proper supervision and adhering to guidelines is selfevident. The Home has been registered since 2006 and Residents moved in near the end of the year, since then it has had one Registered Manager, and two acting Managers. The person overseeing the home at the moment is the Companies Operations Manager who is skilled and experienced in children’s social care and has managed in an alcohol and drugs unit but not in running a Registered Adults Care Home and is unfamiliar with the Care Standards Act 2000 and it’s associated regulations. Since the Inspection he has been appointed to the Managers Post and will be applying for Registration and will undertake the Registered Managers Award. He is working towards building a relationship with Residents and Staff Members and has already introduced some good practice such as the monthly reviews but he needs to develop a better understanding and expertise of working with this particular client group who are people that have suffered varying degrees of brain damage either through an accident or substance abuse and may still have difficulties with addiction to drugs or alcohol. He must also learn about running an adult service within the Minimum Care Standards. The lack of a manager with experience of these people’s needs is effecting the day to day running of the home and the standard of care is not as it should be, leading to compromises in the Resident’s wellbeing. Hopefully the situation will improve now that there is a permanent Manager in place who will develop his skills into this area DS0000066673.V339823.R01.S.doc Version 5.2 Page 11 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): All of the above standards were assessed on this occasion. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people living in High View are given opportunities for personal development, are able to take part in appropriate activities and are part of the local community. They are enabled to keep in touch with their friends and families and are supported to recognise their responsibilities in their daily lives. Their rights are respected and meals are healthy, well cooked. EVIDENCE: For the majority of the time the Inspector was in the house the atmosphere felt calm, relaxed and friendly. Good interaction was seen between staff and the people living in the home, they are provided with the key to their bedroom and staff members were seen to ask service users’ permission before entering bedrooms. One of the people living in the home started shouting and hitting the wall with his fist, mainly due to the disruption caused by the Inspection. The staff on duty responded calmly, and speaking to him quietly, were able to diffuse the situation quickly and prevented the incident escalating out of control. DS0000066673.V339823.R01.S.doc Version 5.2 Page 12 From talking to the Residents and staff it is apparent that Residents are given the opportunity to participate in a number of activates. One person attends a local day centre and staff assist Residents to attend appropriate support groups. The two files that were examined showed that both Residents were attending work two or three times a week in preparation of returning to full time employment and where possible all of the Residents are assisted to find appropriate educational or training courses at a local college. In talking to the Residents, staff and reading the recorded information it became apparent that the Residents activities were not always recorded, and nor were they recorded in a way that enabled those auditing the service to quickly assess details of activities undertaken by the Residents. It has been a previous Requirement that a system of recording daily activates actually undertaken be developed, a recording format has been put in place but is not always been used, staff members should be reminded that the information kept in accurate and timely records is one of the ways that others judge the quality of care offered at the home. This Requirement will be restated. Please see Requirement 1 The Residents are enabled to visit family and friends and often have weekend stays, they can also receive visitors at the home and there are rooms available for Residents to meet guests in private other than their bedroom. The homes guide clearly sets out the expectation that residents will participate in daily housekeeping tasks such as cooking and cleaning their own bedrooms and undertaking their personal laundry. The menu is varied and well balanced, the Residents take part in planning it in advance and will help prepare the meal and some cook for themselves. The office has recently been moved to a smaller room to allow the spacious and well-lit room to become the dinning room, needed because of the increase of beds in the home. During the Inspection a filing cabinet remained in the dinning room and detracted from the homely appearance of the room. It was recommended that the filing cabinet be relocated and it has been. DS0000066673.V339823.R01.S.doc Version 5.2 Page 13 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): All of these standards were judged on this occasion. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in High View receive personal care in the way they prefer and have their physical and emotional needs met. Medication is administered appropriately. This home is not intended to be these peoples permanent home, it is planed for and hoped that the Residents will be able to develop their living skill and to eventually live independently. EVIDENCE: The Residents living in this home are able to speak for themselves and express preferences. Care Plans indicate whether they need assistance with personal care or not and how they want to be helped if needed. People are able to choose when to get up, go to bed or receive support. The home has a key working system and the staff spoken with were aware of their responsibilities as a key worker. All of the Residents are registered with a local Doctor and receive specialist treatments and therapies as needed for their differing medical, physical and emotional needs. DS0000066673.V339823.R01.S.doc Version 5.2 Page 14 The home employs a councillor who works with the Residents and they have regular meetings that are recorded. One of the residents said that they really enjoyed talking with the councillor and valued the meetings. Residents are supported to manage their own medication where assessed as able to do so. The medication, its storage and records were examined during the Inspection and were found to be in order with not omissions or mistakes noted. PRN medication is used; primarily in the form of painkillers but there was no PRN guidelines in place either for general use or for specific to each person or medication. It was recommended that the home develops PRN guidelines that set out what medications can be given, under what circumstances they should given and how and where they should be recorded. This has been done since the Inspection. DS0000066673.V339823.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Both of these standards have been assessed on this occasion. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People living in the home feel that their views are listened to and acted on. A previous Requirement that staff must receive Adult Protection Training has not been met. EVIDENCE: The home gives the Residents and their representatives all the required information in regard to its complaints policy and how to make a complaint. During the visit to the home the Inspector was able to talk to three of the people living in the home and all thought that if they had a complaint to make they would be taken seriously and listened to. It has been a previous Requirement that the Responsible Person must obtain training for staff in relation to adult protection. The training has been arranged but was cancelled on two occasions because staff members failed to attend. This Requirement was restated and training has since been undertaken. Physical and verbal aggression by Residents is understood and is dealt with appropriately, and physical intervention is not used except as a last resort. Staff are trained to deal with aggression in a non aggressive way to defuse difficult situations and how to defend themselves from violence without causing harm to the aggressor or using restraint. DS0000066673.V339823.R01.S.doc Version 5.2 Page 16 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): All of these standards were addressed on this occasion. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People living in this house benefit from a home that is homely and comfortable but some safety matters need to be addressed. Bedrooms meet the Residents needs and lifestyles and promote their independence. Bathrooms and toilets meet requirement and the home is clean and hygienic. EVIDENCE: On the day of the inspection all parts of the home were clean and free from unpleasant odour. Residents are provided with a comfortable and homely environment that is well decorated, maintained and appropriately furnished. With four of the Residents at home the inspector was able to see most of the bedrooms which were spacious, appropriately decorated and furnished except for one that is not occupied at the moment and will only be used for short assessment visits because of its position in the house and restricted view from the window. This room is sparsely furnished and will have to be furnished to requirement before it is used. DS0000066673.V339823.R01.S.doc Version 5.2 Page 17 The Residents of the rooms viewed stated that they very happy with their room and had been provided with everything that they needed. Not all bathroom and toilet doors have been provided with appropriate locks and action should be taken to address this, access to the bathroom or toilet must be available if a resident gets into difficulties in a locked bathroom. This issue was mentioned in the last Inspection Report and will now become a Recommendation. Please see Recommendation 1 The laundry is situated in the basement and fitted with domestic scale appliances to enable service users who are able to wash their own laundry. On the day of the inspection the hot water to some of the sinks and baths was found to be very hot. It is required that hot water temperatures must be regulated and kept to a constant temperature of 43 degrees centigrade. This must be addressed as soon as possible by adjusting the regulator if in place or by fixing suitable mixing valves that keep the water temperature within a safe temperature range at the point of delivery. Please see Requirement 2 Regular checks on the water temperature must be made to alert staff if the regulator fails. Please see Recommendation 2 The radiator in a bathroom, directly opposite the cupboard that contains the central heating boiler, was very hot to the touch and would cause anyone who fell against it or remained in contact with it for any length of time to be burnt. This radiator and any others in the home must be covered to safeguard Residents from burns. Please see Requirement 3 Fire doors within the home were wedged open with doorstops, it is not acceptable that in a residential care home that people are put at risk from fire. Doorstops must be removed and replaced with a means of keeping doors open that are acceptable within the fire regulations. Please see Requirement 4 Those staff members who are responsible for the Health and Safety of the Residents and their colleagues must undertake comprehensive Health and Safety training. Please see Requirement 5 An action plan must be produced that explains how and when the Responsible Person intends to address the Health and Safety Issues that have been highlighted in this report. Please see Requirement 6 DS0000066673.V339823.R01.S.doc Version 5.2 Page 18 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): All of the above standards have been examined during this Inspection. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff are clear of their roles and responsibilities and appear to be competent and knowledgeable of this client group. The Residents are protected by the home’s recruitment policies and practice and staff have undertaken appropriate training, but have not received sufficient supervision. EVIDENCE: Two staff files were examined in detail and the Inspector was able to talk with four members of the staff group. The home’s recruitment policy and procedure is as required and evidence was seen in the staff files that confirmed that it was carried out; Criminal Records Bureau checks are undertaken and two references are obtained, the file also contained photographs and copies of the recruits application, health declaration and other documents as required in schedule 2. All of the staff spoken with clearly demonstrated a commitment to providing a caring and supportive environment for the Residents. Some of the staff spoken to commented that not having a permanent Manager has led to the home suffering from a lack of leadership and has left them feeling unsupported, and this has effected moral. They also commented they DS0000066673.V339823.R01.S.doc Version 5.2 Page 19 were just beginning to get to know the last Manager and had begun to see signs of improvement when he left, they believe not having a Manager has had a detrimental effect on the running of the home. The majority of staff hold an NVQ qualification in care and the home benefits from having a suitably equipped and furnished room for training. Relevant training is offered and a previous requirement that staff receive first aid training has been met, but the one that Adult Protection training must be provided has not been met at the time of the Inspection. The Commission has been informed that the training has now taken place. An induction program has been introduced since the last Inspection but because of the lack of leadership it has not been carried out with all new staff. Formal 1-1 supervision has not always gone ahead either but the Manager is aware of the situation and is taking steps to make amends; on the day of the Inspection a Seniors Staff Meeting was held, the first for some time. There seems to be a lack of knowledge within the whole work team of Health and safety matters and this must be addressed, this has already been mentioned in a previous section. DS0000066673.V339823.R01.S.doc Version 5.2 Page 20 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): All of these standards were assessed during this visit. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The lack of consistent management over the short time this home has been open has caused the day to day running of the home to suffer, it lacks leadership and Health and safety issues are not properly addressed. EVIDENCE: In the short time that this home has been open the Registered Provider who was also managing the home has stepped back from direct management and the person who was appointed as acting manager left and the companies Operations Manager took up post as Acting manager in May. Since the Inspection he has been appointed as the homes permanent Manager. It is still early days to be able to judge the performance of the new Manager, but his expertise lies in working with children and managing in an Alcohol and Drugs unit, for which he appears to be very skilled and qualified, but not in DS0000066673.V339823.R01.S.doc Version 5.2 Page 21 running a Young Adult Residential Care Home within the framework of the National Minimum Standards. It is possible to transfer skills with one client group to another but he needs to develop a greater knowledge of this client group as well of the Care Standards Act 2000 and its related requirements and standards. Staff are committed to providing a good quality of care to the Residents and have a good understanding of their needs but there has not been any constant leadership for an ethos or leadership style to be developed within the home, and this has been negatively commented upon to the inspector. A lack of good leadership in the past has lead to some incidents, caused by a failure to follow agreed care plans and procedures, and has made other professionals doubt the homes capability to care for the people they have placed within the home. Policy and Procedures are in place and staff have access to them. Record keeping is patchy and needs to be tightened up. Contractors are routinely servicing safety equipment and the required numbers of fire drills have taken place and are recorded. Other Health and Safety checks examined at random were not currant and have been neglected since February 2007, mainly due to the person who unofficially took responsibility for making sure they were completed has been off work for an extended period, some of the required safety precautions have not been implemented such as protecting Residents from hot water and radiators. Fire doors are routinely propped open but the fire points are not checked. A Requirement will be made that a schedule of Health and safety checks is developed and that all staff share the responsibility of carrying out these checks, a requirement that staff receive Health and Safety Training has already been made in a previous section. Please see Requirement 7 Food is not routinely probed to check that the optimum cooked temperature has been reached. Fridge and freezer temperatures are taken daily but the recorded temperatures do not fluctuate as would be expected with an oftenopened fridge or freezer. Both readings are a constant 3 degrees or minus 18 degrees. The readings are taken from what the staff believe to be integral thermometers however it is apparent that they are only displays of the temperature it is set at. When the door was left open for an extended period the reading did not change. It was required that an independent means of checking the fridge and freezer temperatures is obtained and used. This has been done since the Inspection. It is imperative that the new permanent Manager undergoes training and becomes registered as fit to manage the home to restore staff moral and to enable the placing bodies to feel confident that the Residents will be well looked after, that they will be kept safe and that programs devised to stabilise and develop the Residents skills will be implemented. DS0000066673.V339823.R01.S.doc Version 5.2 Page 22 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 3 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 2 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 2 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 2 3 2 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 2 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 1 1 3 3 2 1 2 DS0000066673.V339823.R01.S.doc Version 5.2 Page 23 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 YA12 Regulation 16(m) Requirement The Responsible Person must be able to provide written evidence that appropriate social activities are arranged and attended by people living in the home. Previous unmet timescale 01/04/07 Hot water temperatures must be regulated and kept to a constant temperature of 43 degrees centigrade. Radiators in the home must be covered to safeguard Residents from burns. Doorstops must replaced with a means of keeping doors open that are acceptable within the fire regulations. Staff members who are responsible for the Health and Safety of the Residents and their colleagues must undertake comprehensive Health and Safety training. A schedule of Health and safety checks must be developed and all staff must share the responsibility of carrying out DS0000066673.V339823.R01.S.doc Timescale for action 20/08/07 2 YA24 13 20/07/07 3 YA24 13 20/07/07 4 YA24 13 20/07/07 5 YA24 13 20/08/07 7 YA24 13 20/07/07 Version 5.2 Page 24 these checks. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA24 Good Practice Recommendations Not all bathroom and toilet doors have been provided with appropriate locks and action should be taken to address this, access to the bathroom or toilet must be available if a resident gets into difficulties in a locked bathroom. Regular checks on the water temperatures must be made to alert staff if the regulator fails. 2 YA24 DS0000066673.V339823.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection SE London Area Office River House 1 Maidstone Road Sidcup Kent DA14 5RH 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 DS0000066673.V339823.R01.S.doc Version 5.2 Page 26 - 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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