Inspection on 10/01/06 for IW Cheshire Home

This inspection was carried out on 10th January 2006.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

IW Cheshire Home 13/06/07

IW Cheshire Home 29/06/05

IW Cheshire Home 08/02/05

IW Cheshire Home 12/10/04

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

CARE HOME ADULTS 18-65 IW Cheshire Home Appley Cliff Popham Road Shanklin Isle Of Wight PO37 6RG Lead Inspector Janet Ktomi Unannounced Inspection 10th January 2006 12:00 IW Cheshire Home DS0000012501.V277325.R01.S.doc Version 5.1 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 IW Cheshire Home DS0000012501.V277325.R01.S.doc Version 5.1 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. IW Cheshire Home DS0000012501.V277325.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service IW Cheshire Home Address Appley Cliff Popham Road Shanklin Isle Of Wight PO37 6RG 01983 862193 01983 866211 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) Leonard Cheshire Mrs Helen Stedman Care Home 13 Category(ies) of Physical disability (13), Physical disability over registration, with number 65 years of age (6) of places IW Cheshire Home DS0000012501.V277325.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 29th June 2005 Brief Description of the Service: Appley Cliff (IW Cheshire Home) is a residential home for up to thirteen adults aged 18 to 65 years, up to six of whom may be over the age of sixty-five. The provider is the Leonard Cheshire Organisation, which is a leading provider for disabled people in the United Kingdom. Mrs Helen Steadman manages the home. The home is situated on the edge of Shanklin Old Village and is approximately one mile from the main shopping area, the post office, bus and train station. The home has extensive views of the English Channel and is adjacent to Ryleston Gardens. Ryleston Gardens are for public use and have a bandstand, mini golf and café. The home is on two levels and has a passenger lift. All thirteen of the homes bedrooms are for single occupancy, none having en-suite facilities. There is one assisted bath and one assisted shower room. The home has plenty of communal areas including a lounge, conservatory, activities room and dining room. Smoking is only allowed in the conservatory or gardens. The home has gardens that are well maintained and easily accessible to the service users. Twelve of the bedrooms are for permanent service users with the other being used for pre-booked respite care. Day care is offered to a maximum of two people each day. IW Cheshire Home DS0000012501.V277325.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was the second unannounced inspection of this inspection year; the remaining core and a number of additional standards were assessed. The inspection was undertaken on a weekday and lasted three and a half hours during which a tour of the communal areas of the home was undertaken. Discussions were held with staff on duty and many of the people living at the home. Service users stated that they enjoyed living at the home; the food was excellent, varied activities and outings are provided and that they liked the care staff. Care and other records and documentation identified in the report were viewed. What the service does well: What has improved since the last inspection? A number of improvements to the environment have been completed since the previous inspection undertaken in June 2005. These include new automatic opening front doors for which service users have electronic passes and staff an access code. This ensures that people living at the home may come and go as they wish but that others must be admitted by a member of staff to ensure only appropriate people are able to enter the home. The lounge has been redecorated and new furniture provided. A new carpet has been ordered. Some of the service users’ bedrooms have been redecorated and there are plans to redecorate more bedrooms. The kitchen, in the process of being refitted during the last inspection, has now been completed with new food preparation equipment supplied. There are further plans to improve the home in the next few months including work on the gardens to improve access for service users and provide a new patio. IW Cheshire Home DS0000012501.V277325.R01.S.doc Version 5.1 Page 6 The home now employs the maintenance person for an additional fifteen hours per week to provide a driver/carer for the minibus. Three members of staff have also undertaken MIDAS training and are now able to drive the minibus. This provides opportunities for outings and social events throughout the day and evenings. The registered manager has now completed her Registered General Nurse training. 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. IW Cheshire Home DS0000012501.V277325.R01.S.doc Version 5.1 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 IW Cheshire Home DS0000012501.V277325.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 and 3. The pre-assessment documentation and processes are exceptionally comprehensive and cover all the necessary areas to ensure that only appropriate people, whose needs may be fully met, are admitted to the home. EVIDENCE: There has been one admission for long-term care since the previous inspection. The assessment information and care plans in respect of this service user were seen. This service user had previously received respite care at the home on a number of occasions prior to the recent admission for longterm care and was therefore known to the manager and staff. The home was in the process of re-writing the respite care plan to provide the long-term care plan with the service user having been involved as indicated by signatures on the care plan. At the time of the unannounced inspection there was also a service user having her first period of respite care at the home. The records relating to this admission were also seen. The pre-assessment documentation and processes are exceptionally comprehensive and cover all the necessary areas to ensure that only appropriate people whose needs may be fully met are admitted to the home. The assessment begins with a visit to the prospective service user by either the manager and/or the care supervisor. Information is gathered from the service user, the relatives, professionals and medical specialists. The prospective service user agrees the information gathered during the IW Cheshire Home DS0000012501.V277325.R01.S.doc Version 5.1 Page 9 assessment and is involved in discussing how specific needs will be met. The manager and care supervisor considers the information and how these needs will fit in with the needs of the existing service users. Where possible, and especially with long-term admissions, the views of existing service users are also considered. A care plan is written as a result of the assessment process and negotiations about any restrictions on service users take place prior to the placement being offered. Service users’ care plans were viewed during the inspection; these demonstrate how service users’ needs are being met. This includes the involvement of specialist workers such as District Nurses and appointments with clinics and specialists as appropriate. Chiropody, Opticians, Dentists and GPs are accessed with the home providing transport and support. The registered manager is a Registered General Nurse and has knowledge and experience of the service users and their needs. Care staff spoken with had a clear understanding of their roles and confirmed that training was available to meet general and specific service user needs. Previous discussions with the manager indicated a clear understanding of service users the home was able to provide a service for and those whose needs it would be unable to meet. Service users stated that they felt their needs were appropriately met at the home. All standards in this section were assessed during the previous unannounced inspection undertaken in June 2005. IW Cheshire Home DS0000012501.V277325.R01.S.doc Version 5.1 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 the following standard(s): 6, 7 and 9. All long term and respite care service users have individual care plans detailing how health, personal and social needs will be met. Care plans, service users and staff spoken with confirmed that health needs are met, that staff treat service users with respect and that privacy and confidentiality are upheld. EVIDENCE: Two care plans including that of the most recent admission to the home were seen by the inspector. These were very detailed. The service users’ files are organised under headings and identifies individual care, health and social needs and states clearly how these will be met. The service user is involved in developing their care plan (evidence of their involvement includes their personal statements) and sign the care plan. Up-dates of assessments were recorded and are carried out by the key workers for each service user at least every three months and more often if care needs change. The information available enables staff to understand the needs of the service user and how best to meet these. Staff interviewed confirmed that they have access to the care plans, and use them to inform them of the necessary tasks. Risk assessments are recorded and any restrictions on service users would appear to be thoroughly discussed and agreed with the service user. IW Cheshire Home DS0000012501.V277325.R01.S.doc Version 5.1 Page 11 The manager and staff at the home are very keen to encourage service users to make their own decisions. Service users confirmed that they are encouraged to make decisions about day-to-day and longer-term issues. Forms within care plans also request service users to identify their aspirations and things they would like to do or achieve. The home has an activities and volunteers co-ordinator who could fulfil some of the roles of independent advocate with the manager being aware of how she might access external advocates if necessary. Evidence seen in care plans showed that service users had been involved in their assessments and planning of how identified needs would be met. Care staff were clear about confidentiality and disclosing information including an understanding of when they may need to pass on information to a senior member of staff such as adult protection issues. Care plans demonstrate risk assessments where service users have chosen to undertake activities which may pose a danger to the service user. The home is aware of the balance between individual service users’ choice and minimising risk. All bedrooms contain a lockable facility operated either by a key or number code. Neither the manager nor care staff are appointees for any service users. IW Cheshire Home DS0000012501.V277325.R01.S.doc Version 5.1 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 the following standard(s): 11, 14, 15 and 16. The home provides service users’ social and leisure activities in a flexible and varied manner. Service users are provided with opportunities to make choices and to have control over their lives. EVIDENCE: Independence is encouraged and an assessment of the intervention required is made at the point of placement. The home aims to encourage mobility and maximize individuals’ abilities. In discussion with the staff it was clear that the balance of care, and encouragement for independence is understood and taken seriously by the staff. Service users have a range of specialist equipment to move independently around the home and the staff stated that referrals are made to specialists such as speech therapists for communication aids. Service users informed the inspector that they are able to make decisions and choices. Interactions observed during the inspection between staff and service users were warm and friendly and it was evident that service users were able to give their opinions and thoughts to staff. The home has an activities co-ordinator who aims to provide individual and group activities of interest to the service users. The activities organiser stated IW Cheshire Home DS0000012501.V277325.R01.S.doc Version 5.1 Page 13 that she aims to organise activities around individuals’ specific needs and wishes. Service users have all completed a ‘wish list’ of things they would like to do. The activities co-ordinator is now organising these activities, which has included one person have a flight in a light airplane. This service user confirmed that he had really enjoyed the flight and hoped to do so again. Another service user is to have a cruise to Norway supported by two members of staff. Service users have enjoyed going to nightclubs and pubs as well as cafes, shopping trips and visits to places of interest. All service users enjoyed a Christmas meal at a local restaurant. Service users confirmed that they are offered a range of things to do and the well-equipped activities room was seen during the inspection. Discussions with the activities organiser confirmed that she has a budget for both equipment and activities and can decide herself how this budget is spent. A new computer has been purchased for the activities room and the activities person is hoping to get a second printer to enable both computers to have their own printer. There is email and Internet access from these computers. Group activities are also organised and the inspector observed most of the service users enjoying an afternoon music and movement session run by the activities organiser. Service users have a range of specialist equipment to move independently around the home and the manager stated that referrals are made to specialists such as speech therapists for communication aids. The home has two minibuses suitable for transporting people in wheelchairs. The home has provided the maintenance person with an additional contract for an extra fifteen hours per week to drive the minibus for social activities. In addition three other members of staff are able to drive the minibuses providing opportunities for outings in the evenings and at weekends. Transport and support for medical and hospital appointments is provided free by the home with service users paying an individual amount depending on miles travelled for social and leisure activities. The home uses all local facilities such as medical services, hairdressers, shops, pubs and cafes. Service users have been involved in an accessibility study on the Isle of Wight organised by the home. This has so far focused on access to pubs in the Ryde area and a nightclub in the West Wight. Care plans and service users spoken with confirmed that they are supported to participate in their local community. The home has a collapsible hoist that can be used during external activities. Staff support service users to maintain family links inside and outside the home. One service user was waiting for her daughter to visit during the unannounced inspection and informed the inspector that her daughter visits twice a week. Another service user has family on the mainland with the home providing transport and an escort for her to visit them. Other visitors were seen arriving during the afternoon of the inspection. Smoking is only allowed within designated areas of the home. IW Cheshire Home DS0000012501.V277325.R01.S.doc Version 5.1 Page 14 Service users at the home were all very complimentary of the food provided, stating that it was well cooked, with plenty of food and choice available. This standard was fully assessed during the previous inspection. IW Cheshire Home DS0000012501.V277325.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 and 19. Staff provide personal support to service users and ensure that dignity and privacy are maintained at al times. Healthcare needs of service users are assessed and recognised with procedures in place to address them. EVIDENCE: The privacy of service users is seen as a right by the staff. Service users choose their own clothes and hairstyles and are helped with putting on makeup if they wish. Care plans contained moving and handling assessments and details as to how individual service users should be moved and what equipment should be used. There is a key worker system in use within the home. Service users stated that staff support their personal care needs in a caring and dignified manner and feel the staff respect their privacy. Service users have the technical aids and equipment they need to maximise their independence. Individual referrals are made to Occupational, speech and physiotherapists for specific assessments and equipment as may be required by individual service users. Care plans seen contained specific information about service users’ health needs. Service users confirmed that they felt their health needs are met and that they are supported to attend GP or specialist appointments. Transport to attend medical appointments is provided free of charge in the home’s minibus with escorts provided. Staff confirmed that they have received specific training IW Cheshire Home DS0000012501.V277325.R01.S.doc Version 5.1 Page 16 to understand and meet service users’ individual medical needs and understand diagnosed conditions and how these may affect service users. District nurses visit the home as required. Service users seen during the unannounced inspection appeared well and healthy. IW Cheshire Home DS0000012501.V277325.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 The home has a complaints policy with service users opinions sought and respected by staff. EVIDENCE: The home has a clear and thorough complaints procedure that is monitored through the Leonard Cheshire Organisation. Complaints are dealt with promptly and taken seriously. There is a complaints logging form that identifies the complaint, action taken and the service user’s satisfaction with the outcome. Service users spoken to were aware of how to make a complaint and knew how to access the Commission for Social Care Inspection. Care staff spoken with were aware of the action they should take should a service user or one of their relatives wish to make a complaint. The administrator informed the inspector that there had been no complaints since the previous unannounced inspection. Interactions observed between service users and staff during this unannounced inspection were warm and positive and it is the inspector’s opinion that service users would feel able to express concerns to staff, the administrator or the manager. IW Cheshire Home DS0000012501.V277325.R01.S.doc Version 5.1 Page 18 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 the following standard(s): 24 and 30. The premises is suitable for the existing service users providing all single bedrooms and appropriate bathing, WC, and communal space. EVIDENCE: The home is generally well maintained and provides appropriate accommodation for the service users. The home has a range of communal areas, which are accessible to all service users. In addition to the dining room, lounge and conservatory there is an activity room with computers, reference books, games, puzzles and art and craft materials. There is a large garden and a public park very close by that service users can access. The home is bright and attractive with a range of artwork by service users displayed in the hall. The large conservatory and gardens have wonderful views over the bay and the English Channel. The home has a no smoking policy with staff and service users allowed to smoke within the conservatory and garden. All bedrooms are for single occupancy, none have en-suite facilities but all contain a washbasin. The provider, the Leonard Cheshire Organisation, has now decided that it will not be replacing the home with a new building at an alternative site. The manager is therefore now modernising and updating the home. A number of improvements to the environment have been completed since the previous IW Cheshire Home DS0000012501.V277325.R01.S.doc Version 5.1 Page 19 inspection undertaken in June 2005 and more improvements are planned for the future. Those completed include new automatic opening front doors for which service users have electronic passes and staff an access code. This ensures that people living at the home may come and go as they wish but that others must be admitted by a member of staff to ensure only appropriate people are able to enter the home. The lounge has been redecorated and new furniture and television provided. A new carpet has been ordered. Some of the service users’ bedrooms have been redecorated and there are plans to redecorate more bedrooms. The kitchen, in the process of being refitted during the last inspection, has now been completed with new food preparation equipment supplied. There are further plans to improve the home in the next few months including work on the gardens to improve access for service users and provide a new patio. The manager stated, during a telephone conversation following the inspection, that there are plans to provide an additional shower room. The manager also stated that over the next year the central heating and hot water systems are to be reviewed and updated. On the day of the unannounced inspection the home was warm, clean, tidy and free of offensive odours. The home employs two domestic ancillary staff who are responsible for cleaning within the home. Care staff confirmed that all staff have training on the control of infection and safe disposal of clinical waste. Information about infection control and hand-washing procedures were seen around the home together with supplies of liquid soap, paper towels and disposable gloves. There is a sluice on both levels of the home and laundry facilities that are appropriate and designed to prevent cross contamination. Service users all have their own bedding and towels with laundry done individually (not all together). Each service user having specific days for their laundry. Soiled items would be washed separately immediately. IW Cheshire Home DS0000012501.V277325.R01.S.doc Version 5.1 Page 20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33 and 36 The home employs sufficient care staff to meet service users’ needs and ensures that care staff are appropriately recruited, trained, competent and supervised. EVIDENCE: All staffing standards were fully assessed during the previous unannounced inspection undertaken in June 2005. During the inspection service users described the manager and care staff as friendly, kind and helpful. Also stating that they felt able to discuss concerns or complaints with staff or the manager. During the inspection the interactions between staff and service users were warm and friendly with each listening to the other’s opinions and thoughts. Many of the staff have worked in the home for a number of years. Staff demonstrated that they have a good knowledge of the varying communication needs of the service users. Care staff spoken with confirmed that training opportunities were frequently available and staff were actively encouraged to attend training. 42 of care staff have at least NVQ level 2 in care and a further 2 staff are currently undertaking NVQ Level 2. Service users said that staff treat them appropriately and that they feel well cared for by the staff. IW Cheshire Home DS0000012501.V277325.R01.S.doc Version 5.1 Page 21 Duty rotas, care staff and the manager stated that there are four care staff on duty in the morning, three for the afternoon and evening with two awake staff at night. In addition to care staff the home employs catering, domestic, administration, maintenance/driver and activities staff. The home has its own bank staff and does not use external agency staff. On occasions the manager will cover shifts both during the day and at night. The administrator and duty rotas indicated the home has low rates of staff turnover and sickness. Service users and staff spoken with during the inspection felt that there were sufficient numbers of staff on duty to meet service users’ needs. Male and female staff, of various ages over the age of eighteen years, are employed at the home. Care staff confirmed that regular supervision takes place. Supervision records are accessible to the manager and supervisor only. Care staff stated that they are able to talk to the registered manager or care manager if they have any concerns. Care staff also have access to members of the Cheshire organisation who visit the home regularly and complete reports for the Commission. IW Cheshire Home DS0000012501.V277325.R01.S.doc Version 5.1 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 41, 42 and 43. The management arrangements within the home ensure that service users’ needs continue to be met and creates a homely atmosphere in which service users felt valued and are well cared for. EVIDENCE: The registered manager was not present at the time of the unannounced inspection but later confirmed that she has completed her general nursing conversion course and now holds the Registered General Nurse qualification. The manager has previously stated that she would commence an NVQ level 4 in management once she had completed the nursing course. This will be reassessed during the next inspection. The manager has successfully managed the home for a number of years and prior to managing the Isle of Wight Cheshire Home was a registered manager in another residential home. Line managers within the Cheshire organisation support the manager. Service users and staff stated that they felt able to approach the manager and were aware of how to contact senior managers within the organisation. Service IW Cheshire Home DS0000012501.V277325.R01.S.doc Version 5.1 Page 23 user and staff meetings are held with the volunteer co-ordinator chairing the service users’ meetings. The Cheshire organisation undertakes its own quality assurance audits in addition to the Regulation 26 reports submitted to the Commission. A health and safety audit was undertaken the week prior to the unannounced inspection. The administrator stated that the only risk identified had been in relation to some trees in the garden that require attention as they may be dead. During the unannounced inspection a variety of records was inspected. These included visitors book, fire equipment safety check log, care plans, risk assessments, accident and incident records, menus and duty rotas. All were found to be well maintained and appropriately stored. At the time of the unannounced inspection there were no obvious risks to health and safety of service users, visitors or staff. Staff stated that they receive training in manual handling, first aid, health and safety, fire awareness and food hygiene with regular updates and refresher training provided. Safety notices were seen appropriately positioned around the home and infection control equipment was available for care staff. Covers are fitted to all radiators. Appropriate measures to ensure the security of the premises were in place. The relevant insurance certificates were seen during the unannounced inspection. The home appeared financially viable, being full at the time of the unannounced inspection. IW Cheshire Home DS0000012501.V277325.R01.S.doc Version 5.1 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. 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 4 3 4 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 X 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 X 33 3 34 X 35 X 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 X 3 X LIFESTYLES Standard No Score 11 3 12 X 13 X 14 4 15 3 16 3 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 X X 3 3 X X 3 3 3 IW Cheshire Home DS0000012501.V277325.R01.S.doc Version 5.1 Page 25 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action 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 IW Cheshire Home DS0000012501.V277325.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection Southampton, Portsmouth and Isle of Wight Ground Floor Mill Court Furrlongs Newport, IOW PO30 2AA 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. 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