Inspection on 11/07/05 for Homelands

This inspection was carried out on 11th July 2005.

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

The inspector 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 20 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Homelands 13/11/08

Homelands 08/01/07

Homelands 05/10/05

Homelands 22/02/05

Homelands 05/08/04

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 Homelands Forge Hill Aldington Ashford Kent TN25 7DT Lead Inspector Lois Tozer Announced 11 July 2005 9:45 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Homelands H56-H05 S23446 Homelands V227284 110705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Homelands Address Forge Hill Aldington Ashford Kent TN25 7DT 01233 721229 01233 721299 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Canterbury Oast Trust CRH 8 Category(ies) of Care Home - Learning Disabilities registration, with number of places Homelands H56-H05 S23446 Homelands V227284 110705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22nd February 2005 Brief Description of the Service: Homelands is registered to provide accommodation, personal care and support to eight people who have a learning disability, but are physically able. The premises is a listed 17th Century house which is approximately 15 minutes walk from the village shop and 10 minutes from the local pub. It is owned and operated by The Canterbury Oast Trust (C.O.T.), a charitable organisation and is managed by Ms Victoria Wardrope. Situated in a rural location overlooking Romney Marsh, the house has many interesting features, and is extremely attractive inside and out. Communal facilities include a poolroom, spacious dining and lounge areas, and a large garden with a recently laid patio. The kitchen and laundry facilities are fully accessible. All bedrooms are registered for single occupancy. Staff have their own dedicated sleep-in facilities and office area. Access into the wider community relies on the homes transport (the public bus service being reported as infrequent). There is currently one dedicated vehicle for communal use, a second communal vehicle will be supplied during 2005. A woodland management project operated by C.O.T. is situated nearby; this is used for service user work experience and recreational use and is also open to the public. Homelands H56-H05 S23446 Homelands V227284 110705 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This statutory announced inspection took place between 09.45 and 16.45 on 11th July 2005. Since the last inspection, the home has experienced a change of manager and has had some staffing turnover. From April to June 2005, the deputy managed the home whilst a new manager was appointed; this was Ms Victoria Wardrope, who took post on 1st June 2005, and assisted this inspection process. The deputy transferred to a different service shortly after this date; therefore, the residents have experienced some level of disruption, although the core group of staff have remained the same. The manager has not had sufficient time to make the changes necessary for the greater empowerment of the residents living at the home, but had already identified many of the areas noted during the inspection as in need of improvement. Eight people currently live at Homelands, all have been in residence for a number of years. Five residents gave their input to the inspection process, two were quite expressive, and where possible, their comments and indications are included within this report. One resident was on a family holiday. During this inspection a range of evidence collection methods were used, these being; conversations with service users, staff and management; reading of care, support and goal plans and risk assessments; general observation and of activities taking place; documentation relating to training, medication, staffing levels, induction, security of finance; a tour of the communal areas and some residents’ personal bedrooms. Eight service user and seven relative feedback cards were received back. In the main these were very positive, with relative comments including ‘…staff at Homelands are very committed and supportive of residents’. ‘Staff always answer any queries that I may bring up’. One relative felt that staff were ‘sometimes too keen to go to the GP for minor ailments … would prefer that time is given for the body to heal itself or use homeopathic remedies’. Resident comments indicated that everyone liked living at the home, felt well cared for and were treated with respect, but four of the cards returned said that they would like to be more involved in the decision making within the home. These comments were fed back to the manager for quality assurance consideration. The house is a pleasant, well-presented abode, especially from the front. Some maintenance work is planned to take place this summer to improve the weather worn and damaged paint and woodwork to the rear, but as yet, no firm date has been set. Comments from residents during the inspection included; ‘… we are looking forward to our holiday on the Isle of Wight.’ ‘… think I should be able to make Homelands H56-H05 S23446 Homelands V227284 110705 Stage 4.doc Version 1.30 Page 6 my own lunch more often’. ‘I helped butter the bread for lunchtime’. ‘I like my key worker sometimes’. ‘I like my room, and my neighbour’. Some positive non-verbal communication between staff and residents was observed, using Makaton signing language to converse and have a joke. One resident was observed being well supported by Homelands staff to carry out plant care tasks in the woodland management facility. What the service does well: What has improved since the last inspection? What they could do better: Several requirements made (and in essence met) at the previous inspection require continual development. The ethos of the organisation is to enable positive development of the residents through opportunities and training, to develop individual potential and be equal members of society. Much of the support described in the individual plans and witnessed during the inspection was not developmental and did not present individuals with equal Homelands H56-H05 S23446 Homelands V227284 110705 Stage 4.doc Version 1.30 Page 7 opportunities. One example was the manner in which individual plans had been written, with little or no demonstrated input from the residents in question. The emphasis had the appearance of ‘how to do’ care, rather than ‘how to enable’ the person to better self-care with support. The manner in which some parts of the plans were written would not be understood by the resident if read back to them, and some phrasing was rather judgemental without any evidence to back up an ‘inability’. A second example was the lunchtime meal was sandwiches for four residents, (the other 3 had made lunch boxes up earlier in the day) but despite having 4 staff on duty, only one resident participated in the preparation, the buttering of the bread; the others were presented with their sandwich covered with cling film. Staff sandwiches were presented prettily, cut into ¼s, presented in an attractive manner and contained salad, whereas residents were cut in half and had no salad, and this was an obvious difference. As staff are provided with a meal with residents, it is important this type of discriminatory practice does not take place and that all general day-to-day chores take place while supporting the residents to achieve better skills through practice and encouragement. 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. Homelands H56-H05 S23446 Homelands V227284 110705 Stage 4.doc Version 1.30 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Homelands H56-H05 S23446 Homelands V227284 110705 Stage 4.doc Version 1.30 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, 5 The service user guide is full of valuable information to aid prospective service users to decide if the home is suitable for them, but quality assurance processes must highlight when the home is not meeting their own aims and objectives. The assessment process has not been used for many years, but the past procedures have been robust. Individual written contracts state the terms and conditions of residency in a manner that can be understood by service users. EVIDENCE: A very informative statement of purpose and service user guide has been developed and contains all the information a prospective resident requires to make a decision if the home can meet their needs. Minor adjustments to acknowledge the recent change in manager need to take place. However, developmental promises made in this document must be kept under constant review to ensure that the home is fulfilling its aims and objectives; to increase resident’s involvement in the running of their home. All new service users would undergo a full needs assessment prior to a placement being considered, and documentation previously seen demonstrated that this covers the range of this standard. The home has a stable service user group and as such has not had any new admissions for many years. A recent piece of work on contracts has provided each individual with an easy to read and understand statement of their terms and conditions of residency, using symbols and pictures where this aids understanding. Homelands H56-H05 S23446 Homelands V227284 110705 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7, 8, 9, 10 Although the service user plans have been recently updated to be more specific, they do not offer the individual the opportunity for personal development through decision-making and participation in day-to-day matters. Service user comments indicated improvement in decision making within the home is required. Risk management appears to be rather over cautious in some well-assessed areas and absent in others. Information is stored in a safe and secure way. EVIDENCE: Two individual plans were examined and have been re-written from a recent basic needs assessment describing the level of care deemed, by staff, to be appropriate to the individual. There is no evidence that the plan was written in consultation with the resident and there was little indication as how staff should promote greater independence. The wording in one of the plans was quite jargon filled and would not be easily understood by the resident it applied to (and unlikely to be understood by the average reader without the authors assistance). Additionally, some of the wording was quite demeaning and did not reflect the adult status of the person it was written about. The emphasis was on ‘doing care’ to residents, rather than supporting development thorough a structured decision-making process. Four of the eight comment cards Homelands H56-H05 S23446 Homelands V227284 110705 Stage 4.doc Version 1.30 Page 11 received from residents stated that they wished to be more involved in decision making within the home. The manager voiced her opinion that a person-centred approach should be used, to enable residents to take a greater level of control; this would certainly be more empowering. Risk is assessed and monitored, a recent risk assessment conducted was straight to the point and clearly stated the actions to reduce risk. However, a risk assessment completed regarding a service user’s transportation of medication stretched to 5 pages and had a fuzzy conclusion, despite the service user’s known ability to safely carry out the task for the past 3 years (acknowledged on the assessment itself). Conversely, service users have new bank accounts with ‘chip & pin’ facility, and the vulnerability of this has not been assessed. This forms a requirement. Understanding the importance of risk consideration is essential, but so is the need to enable the staff and service user to benefit from the process by keeping it simple and to the point and for it to be used as a tool for enabling opportunity. All documentation was stored in the staff and managers office, these areas are kept locked when not in use. Homelands H56-H05 S23446 Homelands V227284 110705 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11, 12, 13, 14, 15, 16, 17 Residents’ personal development opportunities appear to have declined since the last inspection. All residents have opportunities participate in educational and occupational activities that they enjoy. Although the home is situated in a rural location, regular trips into the village and wider community are facilitated. A range of leisure activities chosen by residents is available on a regular basis. Residents are supported to maintain close family connections and have relationships. Residents would benefit from greater inclusion in the daily routines of the home, including the opportunity to prepare their own meals with staff support. EVIDENCE: The resident group living at the home are lively and interested people who attend external courses to develop their skills, but the opportunities available in the home to practice life skills were not a feature on the staff shift planner, nor were being offered as a matter of course. As such, the individual plan must be designed to promote the individual’s development and support needs so staff can constantly offer opportunities to practice skills and increase the level of independence in a way that is acceptable to the individual. The plans Homelands H56-H05 S23446 Homelands V227284 110705 Stage 4.doc Version 1.30 Page 13 seen were very much about having care done for the person, not about supporting the person to develop greater skills. The level of support given to a person must be revised, rather than the opportunity to be more self-caring simply removed in favour of staff ‘applying care’. When asked, a resident said that he would like to make his lunch each day, but no resident was, during this inspection, actually supported to do so, and a staff member confirmed that people were not habitually supported to do this. Some residents have some difficulty in expressing their decisions, so it is vital that the home and staff offer the opportunity, in an appropriate manner, to residents to voice their opinions and views, and be actively supported to participate in day-to-day activities. During the day, a staff member was supporting a service user during a work style opportunity to water plants. The individual who was being verbally guided to achieve the task was clearly enjoying this. The level of happiness and achievement was evident, and this level of support would be enormously beneficial if transferred into the daily routines of the house. Homelands H56-H05 S23446 Homelands V227284 110705 Stage 4.doc Version 1.30 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19, 20 It is not clear if personal support is given in the manner the individual would prefer it; supporting documentation does not promote the development of self care skills. Each individual has access to a range of health care professionals; all health care needs are addressed swiftly. Medication is generally well managed, however some shortfalls were seen. EVIDENCE: Two personal support plans were read; both were written in a way that described how care would be applied, by staff, to the person, rather than how the individual would be supported by staff to conduct their own personal care. One entry indicated that further development in an area had been written off as ‘past attempts have indicated little real motivation’; this was in reference to a practical personal care need that could be conducted safely by the individual if given the right level of support. It is really important that a quality assessment of individuals strengths and needs take place and dismissive, assumptive practice by staff is discontinued. A greater level of resident involvement, using a person centred approach, would be beneficial. Physical and mental health care issues are well documented and followed up. Many aspects of medication management have improved and plans are in the pipeline for some individuals to take greater control over their own medication administration and storage. Some work has already been successfully conducted, and the manager aims to have a training and development plan in Homelands H56-H05 S23446 Homelands V227284 110705 Stage 4.doc Version 1.30 Page 15 place to help the individuals learn to transfer their skills into practice in the near future. The shortfalls noted were that codes, on the administration records, did not make sense; directions for a topical cream did not say which part of the person it was for, and further information could not be found in the current care plan; handwritten entries were not double signed for accuracy. Homelands H56-H05 S23446 Homelands V227284 110705 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 23 Standard 23.6 was the only part of this standard inspected. Risk in relation to service user finances requires assessment; this is also detailed in standard 9 and below. EVIDENCE: Canterbury Oast Trust have assisted service users to open up individual bank accounts, and receives their personal benefits by direct payments, this is a met requirement of previous inspections. Each individual has a monthly statement from the bank, however access to cash is via a ‘chip & pin’ card. Where individual residents can memorise and keep the pin number safe, this is a really effective set up, but several residents are unable to support this system without a 3rd party having knowledge of their pin number. Assessment of risk is absent, and this current situation leaves both residents and staff vulnerable. A requirement to assess the situation and make the necessary changes to improve the safety (such as access to a cheque book) has been made. Money held by the home on residents’ behalf is well accounted and audited regularly. Homelands H56-H05 S23446 Homelands V227284 110705 Stage 4.doc Version 1.30 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 25, 26, 27, 28, 29, 30 The home is comfortable, homely, and safe, but external decoration remains outstanding. Bedrooms are highly personalised and are enjoyed by the individuals. Shared space is extensive, well maintained, and enjoyed by all residents. There is no assessed need for any specialist equipment in the home. Some improvements in two WC areas are required, which has an effect on maintaining a good standard of infection control and safety. EVIDENCE: The house is very much liked by the residents, who enjoy the extensive communal space, gardens, and patio area. Other than the offices, no parts of the home are restricted to residents. All bedrooms are registered for single occupancy, some are very large and others are quite small, but all residents giving feedback said they liked their rooms very much. There is a communal room with a pool table and computer for unrestricted recreational use and a large TV lounge. Staff benefit from dedicated facilities to sleep in, shower and store personal belongings. Internally, the home is very well maintained and benefited from a kitchen refurbishment in the recent past. The residents have support from a staff member who is dedicated to help with domestic duties. Homelands H56-H05 S23446 Homelands V227284 110705 Stage 4.doc Version 1.30 Page 18 Decoration to the rear of the premises has been an ongoing requirement, which is planned to be addressed summer 2005, but no start date has been arranged. A commencement date has been required, as it is important that this work is carried out before the winter months create further problems. All facilities are clean and hygienic, but two shortfalls requiring attention are; a WC facility has had the hot water for the washbasin closed off, for reasons unknown. The staff toilet seat requires securing to prevent accidents. Homelands H56-H05 S23446 Homelands V227284 110705 Stage 4.doc Version 1.30 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 34, 35, 36, All staff positions have a job description stating roles and responsibilities. A great deal of training has been provided to the staff, and many hold NVQ awards. The staff team is not as effective as it should be in respect of the promotion of service users’ skills and involvement in the running of the home. The recruitment procedures are robust. Supervision frequency has lapsed during the management change period. EVIDENCE: The job descriptions for each staff member make clear that the role of the staff is as a supporter in the development of the service user skills and achievements. 80 of the team have an NVQ qualification in supporting people and have received a wide range of statutory training to enable them to carry out their roles safely. Some training has been service user specific, such as epilepsy awareness, Makaton and challenging behaviour. During this inspection, it was observed that staff carry out many meaningful, day-to-day, tasks without residents. Observed were cleaning, ironing and meal preparation. Residents were present during these times, but were passive observers, not active participants. The involvement of the residents in the running of their own home is vital to the provision of an inclusive, supportive ethos that provides equality for all. The shift planner did not indicate any resident involvement in tasks, and if an individual was not scheduled for a Homelands H56-H05 S23446 Homelands V227284 110705 Stage 4.doc Version 1.30 Page 20 planned external activity, here was a large degree of ‘free time’, while staff got on with what should be the resident’s house care responsibilities and duties. This said, staff were seen to support individuals really well in activities outside of the home, offering support and guidance to achieve a goal. This needs to be transferred into the ethos of all staff when working in the home. Training provided so far does not include equal opportunities; the induction programme is still not linked to Learning Disabilities Award Framework, as stated in the standards, and would clearly be of benefit to staff that are new to this line of work. Improvement in service user involvement is a requirement and the way this is achieved is strongly recommended by providing training that supports staff to understand the reasons why people should be actively supported and give staff the skills to put the theory into practice. Supervision frequency has lapsed due to the management change; however, these are now scheduled to take place. The human resource department confirmed recruitment procedures are in line with the regulation amendment. Homelands H56-H05 S23446 Homelands V227284 110705 Stage 4.doc Version 1.30 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 38, 39 The manager is new to her post; therefore, the ethos is being re-established. The home runs efficiently, but does not focus on the total inclusion of service users. There is no quality assurance system currently in operation. EVIDENCE: Having been in post for a very short period of time, Ms Wardrope has been getting to know both residents and staff, but has a clear picture of how the home needs to change in order to increase the level of service user involvement in day-to-day matters. The ethos of the home is not as inclusive to residents as it must be, and there was a degree of tension in the atmosphere during this visit that has not been previously present. Observed practices described earlier (the difference in content and presentation of staff sandwiches compared with residents, the low level of resident involvement in domestic tasks) highlight that the ethos must be challenged and improved. That this behaviour took place during an inspection is additionally concerning, as it would suggest common practice. A previous recommendation that the quality assurance survey to ascertain what is really important to the residents Homelands H56-H05 S23446 Homelands V227284 110705 Stage 4.doc Version 1.30 Page 22 remains outstanding, although some initial work has taken place within the organisation. Homelands H56-H05 S23446 Homelands V227284 110705 Stage 4.doc Version 1.30 Page 23 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 3 x x 3 Standard No 22 23 ENVIRONMENT Score x 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 2 2 2 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 2 4 N/A 2 Standard No 11 12 13 14 15 16 17 2 3 3 3 3 2 2 Standard No 31 32 33 34 35 36 Score 2 3 2 3 2 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Homelands Score 2 3 2 x Standard No 37 38 39 40 41 42 43 Score 2 2 1 x x x x H56-H05 S23446 Homelands V227284 110705 Stage 4.doc Version 1.30 Page 24 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA1, YA6,YA38, YA39, Regulation 6 (a - b) 24 (1 - 3) Requirement Quality audit the service provided against the statement of purpose / service user guide and address shortfalls through supervision and training methods. Service user plan is to be written in consultation with the individual & presented in an understandable format. Must identify the strengths & needs and show what support will be put in place to promote greater independence and maintain skills. Opportunities to practice meaningful life skills with staff support to be improved and built into the daily shift planner. Risk assess service user access to money using the ‘chip & pin’ facility, taking action to remedy if required. Residents to be activly supported to prepare meals. Medication administration short codes must be relevant. Handwritten entries must replicate the prescribed directions and be countersigned for accuracy. Timescale for action 01/10/05 2. YA6, YA18 12 (3, 4) 14; 15 01/10/05 3. 4. YA 7, YA8, YA11, YA16, YA33, YA38 YA9, YA23 18 (1, a) 12/08/05 13 (4,b) 01/09/05 5. 6. YA17 YA20 16 (2,h) 13 (2) 12/08/05 12/08/05 Homelands H56-H05 S23446 Homelands V227284 110705 Stage 4.doc Version 1.30 Page 25 7. 8. 9. YA24 YA27, YA30 YA35 23 (2,b) 23 (2,j) 17 (2) 18 (1,a,c) 10. YA39 12 (5) 15 (1 - 2) 24 (1-3) Directions for creams must say where they are to be applied. Advise CSCI the date of commencement for external decoration to take place. Safely secure staff WC seat Allow hot water flow to boot room WC. (Previous requirement, timescale extended from 01/04/04). Staff to receive structured induction and foundation training within a LDAF framework. (Previous recommendation) Quality assurance survey for service users; ascertain, through the panel meetings what is really important to the service users themselves and measure this as well as the promises made in the statement of purpose & service users guide. Present in an easy to understand way. Seek information from learning disability focused research institutes such as B.I.L.D; Sector Skills Council (TOPSS) through L.D.A.F. & other forums. Develop Q.A. survey for parents & significant people in the service users lives. Publish outcomes in a useable format to work towards improvement & development. 01/08/05 01/09/05 01/01/06 01/01/06 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 YA9 Good Practice Recommendations (Previous recommendation) Risk assessments pertaining to service users are salient and to the point and reflect the benefit of an activity or risk situation and, where appropriate, have been done in consultation with the H56-H05 S23446 Homelands V227284 110705 Stage 4.doc Version 1.30 Page 26 Homelands 2. 3. YA35 persons they apply to. Training to include active support skills, equal opportunities, support, goal and shift planning. Homelands H56-H05 S23446 Homelands V227284 110705 Stage 4.doc Version 1.30 Page 27 Commission for Social Care Inspection 11th Floor, International House Dover Place Ashford Kent TN23 1HU National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Homelands H56-H05 S23446 Homelands V227284 110705 Stage 4.doc Version 1.30 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!