Inspection on 01/08/06 for Langley House

This inspection was carried out on 1st August 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

Langley House 20/06/08

Langley House 05/07/07

Langley House 02/03/06

Langley House 15/11/05

Langley House 31/03/05

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Langley House Langley Marsh Wiveliscombe Somerset TA4 2UF Lead Inspector Loli Ruiz Key Unannounced Inspection 1st August 2006 10:00 Langley House DS0000060091.V301451.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 Langley House DS0000060091.V301451.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. Langley House DS0000060091.V301451.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Langley House Address Langley Marsh Wiveliscombe Somerset TA4 2UF 01984 624612 01984 624797 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) Voyage Ltd Mrs Rebecca Patricia Parsons Care Home 14 Category(ies) of Learning disability (14), Physical disability (1) registration, with number of places Langley House DS0000060091.V301451.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Registered for 14 persons in categories LD and PD. There is a low doorway in the bedroom on the second floor within the three bedded unit. This room is suitable only for service users who are under 5 ft 2 in height. Registered for one named person with a learning disability and physical disability to reside within the main house. (Please see letter from CSCI dated 12/10/04). 2nd March 2006 Date of last inspection Brief Description of the Service: Langley House is a large detached home set in its own grounds. It is registered with the Commission for Social Care Inspection to provide care for up to fourteen people between the ages of 18 - 65 years who have a learning disability. The home can also accommodate one client who also has a physical disability, within the main house - which has two ground floor rooms accessible for such clients. It also has eight first floor bedrooms. There is a separate annexe providing accommodation for up to three people, and a self-contained flat for one person, at the site. The Registered Provider is Voyage Ltd. Mrs Rebecca Parsons (the Registered Manager named above) has now left the home and registration of Mr Mark Coxwell, the new manager is nearly completed. Langley House DS0000060091.V301451.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspector was at the home for nearly eight hours, for this unannounced inspection. The new Manager, Mark Coxwell, was out as the inspector arrived but soon returned and assisted the inspector at different times thorough the day. The inspector was informed that there were altogether 10 service users living in the home. Three female service users lived together in the Annexe. All other service users were male, one of them lived in the flat. The inspector had contact with the majority of service users as she toured the buildings and had closer contact with the three women in the annexe and the service user in the flat. Service users are provided with a range of opportunities in the home, local community and nearby towns engaging in activities of daily living, such as shopping, leisure, therapeutic and social opportunities. The inspector had contact with most of the staff on duty and had private discussions with a number of care assistants, senior carers and the manager. Three of the staff spoken with were new and their files were inspected to evidence the recruitment, vetting, induction and support systems in the home. Some of the staff were key-workers to service users chosen for case tracking and their support was discussed with them and their personal care and support plans inspected. No comment cards have been received by CSCI since the last inspection in March 2006. The majority of standards as well as all key standards were inspected and met during this visit. What the service does well: The needs of service users are fully assessed and good transition work is carried out to ensure the home can meet prospective service user’s needs. Service users continue to receive good assistance to make appropriate choices on a daily basis, including taking appropriate risks. Service users lives continue to be enriched by the individual activities provided. These are chosen from a range offered, according with the person’s expressed preferences. Staff assist with maintaining frequent contact with important others and relatives participation in the care and support of service users is encouraged. A three week menu is planned taken into consideration each person’s preferences and dietary needs and planned to provide balanced meals. A record of the food prepared and eat by each service user each day is Langley House DS0000060091.V301451.R01.S.doc Version 5.2 Page 6 maintained enabling staff to monitor service user’s diet. Good quality food choices are encouraged when eating out of the home. Service users have access to NHS, private practitioners and social care specialists. Their medication is reviewed and adjusted to need. There are good systems for ensuring views are noted and concerns or complaints are addressed. The complaints procedure is displayed. Service users live in a home that benefit from attractive surroundings, from a large, safe and well equipped garden and personalised private spaces, within the spacious accommodation in each house. Houses are maintained to an adequate level of hygiene and attention is paid to the control of infection. Good recruitment, vetting, induction and support practices are in operation. Sufficient staff are employed with appropriate variety of skills and training to meet service users’ needs well. There is a positive approach to staff training and supervision. The home is well managed and benefits from an open management style and from a cohesive and positive staff team. What has improved since the last inspection? What they could do better: Risk assessments should be completed for everyone, should directly link to the plan of care and support and to the behaviour management plan, and be reviewed and updated at as frequent intervals as necessary, and no less than 6 monthly. Langley House DS0000060091.V301451.R01.S.doc Version 5.2 Page 7 All staff members should have all mandatory training (including an “understanding of medicines” course for those involved with medicines), and updates of training in due time. All staff should have the minimum of 5 paid training days per year. The home should look for ways to make the communal areas in the main house more homely and ensure that repairs are carried out promptly to plaster, tiles and wallpaper, where necessary. A quality assurance tool should be used to better evidence existing good relations with parents and other persons involved with the home, to evidence that everyone has opportunities to feedback and to inform them of feedback received. 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. Langley House DS0000060091.V301451.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Langley House DS0000060091.V301451.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4, The quality in this outcome group is good. New service users’ needs are assessed, they are provided with opportunities to get to know the new staff and new home and are given information in appropriate formats. The views of service users are sought. Their plan of care and support reflect their individual preferences and support provided to lead as fulfilling daily lives as possible. EVIDENCE: Discussions took place with staff of transition work done with a new service user. Examination of community care assessment and care and support record of the new service user were examined including personal contract detailing rights and responsibilities in pictorial form that the service user can understand. The inspector spoke with the new service user who was happy with the lifestyle experienced in the home, evidenced having made friendships and of warm relations with staff. Contentment was also expressed with the house and other service users in it and with responsibilities given. The service user was very happy to show the inspector around the house, the garden and pet before leaving the home for the morning planned activity with staff. Langley House DS0000060091.V301451.R01.S.doc Version 5.2 Page 10 Langley House DS0000060091.V301451.R01.S.doc Version 5.2 Page 11 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): 6,7,8,9 The quality in this outcome group is good. Service users benefit from an individualised approach to their care and support with good outcomes. Service users are provided with opportunities for choice within a good range of acceptable options in their daily lives. Service users are supported according to a persons centred plan with goals to minimise problematic or dangerous behaviours and improve wellbeing and life opportunities. The risk assessment tool used is under review and work is taking place to ensure that the risk assessment is documented for all service users. EVIDENCE: Inspection of three care and support records showed that all three individuals had comprehensive behaviour management plans (BMP). Observation charts were used and a list of possible triggers with guidance for primary and secondary interventions strategies, aimed at minimising problematic behaviours, given. Further guidance was given in the event of having to use Langley House DS0000060091.V301451.R01.S.doc Version 5.2 Page 12 physical intervention as a last resort. Techniques used were those taught by the BILD accredited organisation providing staff training. In addition to the plan, separate risk assessments were present for service users most at risk. It made for a bulky, though informative document. Voyage is at present reviewing the format to separate general risk elements from individual areas of risk to better manage this area. So not everyone has yet a fully documented risk assessment- although the outcomes for service users are very good. Discussion with the manager evidenced that he is in the process of compiling detailed BM plans for everyone and is working on a priority basis. Discussion with key workers evidenced their understanding of the BMP, personal knowledge of the service user’s needs and their input to the plan via the monthly reports and contact with their supervisors, daily and during supervision. Observation of service users improved behaviour and life opportunities. From records, personal knowledge and observation of activities on the day. A list of the activities offered to persons chosen for case tracking was provided. Langley House DS0000060091.V301451.R01.S.doc Version 5.2 Page 13 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): 11,12,13,14,15,16,17 The quality in this outcome group is good. Service users benefit from positive interventions that bring about significant personal development. All service users have a good programme of appropriate daily activities to choose from. Service users are assisted to maintain frequent contacts with their relatives and friends and to be part of their community. Staff are aware of the service users rights in every aspect of their lives and uphold these in their daily practice. Staff assist service users at mealtimes and plan to provide balanced and nutritious food. EVIDENCE: Langley House DS0000060091.V301451.R01.S.doc Version 5.2 Page 14 Marked improvement in behaviours that had previously isolated some individuals have translated in accessing social, leisure and activities of daily living, than previously where significantly restricted. There is a good range of appropriate activities that are guided by service user’s preferences and assessed needs. Service users have annual holidays. For example the three service users in the annexe had been together on holiday with 4 staff. Staff and a service user who could, testified that all three had enjoyed the experience. Holidays were also planned for other service users. Service users are part of the local community and are making good links with individuals there. Some now address them by their name when accessing local shops and pub. Service users have frequent contacts with important others as staff enable home visits, frequent telephone calls and organise social events. They are taken to visit relatives and assisted to communicate by telephone and correspondence. The manager contacts parents on a weekly basis to update them with events. Daily routines are organised according to individual needs and preferences as observed during the day and evidenced in their records, as well as by the observed service users’ apparent contentment. Individual responsibility is encouraged. Staff work to provide a balanced diet and relaxing meal times, staff eat with service users and provide the support that they need. Meals provided and eaten by each service user is recorded. Observation of meals showed staff assisting service users and dealing with unexpected behaviours in a calm and supportive manner. Langley House DS0000060091.V301451.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 The quality in this outcome group is good. Service users are supported to have the lifestyle they prefer, according to the staff’s knowledge of their individual preferences. Service users health, emotional and social care needs are looked after. The medication area is well managed and staff have their competencies reviewed but they would further benefit from a specific medicines course and associated updates. EVIDENCE: The personal support is person centred resulting in service users improved behaviours and life opportunities, as observed during the inspection, from the inspector’s personal knowledge of some service users and also from staff testimonies about work done and records inspected. Records also evidenced service users accessing NHS and private services for health related checks and therapeutic interventions. There were NHS staff and a social worker in the home on the day of the inspection, visiting specific service user/s. The latter are all referred by a local authority and have social workers who carry out annual reviews and have more frequent contact as Langley House DS0000060091.V301451.R01.S.doc Version 5.2 Page 16 necessary. All service users medication had been reviewed during 2006. Some medications had been reduced or discontinued as behaviours had improved. The medication area was well managed. All medication is appropriately signed and recorded. Medication was also appropriately stored and administered. There is a corporate medications policy and staff competencies are reviewed, according to the policy. Staff have been provided with BOOTS training in the management of the MDA system, however, staff should also be provided with a “care of medicines” course followed by associated updates. Langley House DS0000060091.V301451.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 The quality in this outcome group is good. Service users are protected by the open culture promoted by the manager, by person centred support practices and by well supported staff who have had specific training in protection issues. Service users are also protected by the complaints and protection policies in operation. EVIDENCE: The complaints procedure was clearly displayed at the entrance of the home. For service users who could understand them the manager has contracts that include what to do if unhappy about anything in pictorial formats. Observation charts were used, service users’ likes and dislikes were noted and action taken to meet people’s preferences, to diminish self- harm, promoting behaviours that lead to integration within the home, and also to improved social and leisure opportunities outside. There have been no new complaints from service users or their advocates. The manager and staff had open attitudes and staff evidenced having the support they needed from the management and from, what they considered a very good, cohesive team. The manager, staff and records seen evidenced that there are good relations with parents and advocates. The manager informs parents of progress with each service user on a weekly basis. Parents input in the care and support plan was evidenced by their signature. This contact was also evidenced during Langley House DS0000060091.V301451.R01.S.doc Version 5.2 Page 18 discussions with key-workers who take service users for home visits and help them with correspondence and telephone contact. Staff seen evidenced good knowledge of the company’s policy for POVA and their duties under the Whistle Blowing Policy. The company provides training in POVA topics for all staff (although there are gaps in the training chart) and staff seen on the day have relevant knowledge and understanding. Staff members were observed relating to service users in a friendly and respectful manner with positive responses from service users. Langley House DS0000060091.V301451.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 28, 30 The quality in this outcome group is good. Langley House provides a comfortable and safe home for service users IN a most attractive location. The home would benefit from more frequent maintenance to repair damaged walls and from homely furnishings in the living and dining areas of the main house. EVIDENCE: The home is surrounded by attractive large and well-maintained gardens and service users benefit from a large safe area that is equipped for their enjoyment. Two of the three houses that form the home were visited. Private areas reflected its occupant’s individuality. Communal and private areas in the 3-bedded house were homely and had good outlook and open access to a safe garden. There was also open access to bedrooms. Langley House DS0000060091.V301451.R01.S.doc Version 5.2 Page 20 Communal rooms in the main house were spacious though rather empty of furnishings or homely décor with just the essential furniture. There were pleasant pictures in some areas but not in the living room. The dining room was also rather bare with just essential furniture. Altogether the main house had a more institutionalised feel than the annexe, which was homely and welcoming. Some bedrooms doors were kept unlocked for service users who liked to spend time there. Other doors were locked to maintain private areas safe while service users were engaged outside or in other areas. The home has institutionalised key pads on all doors but it is important to note that service users had staff assistance at all times and that staff were guided by what service users wanted to do and where they wanted to be. Often they were participating in planned activities outside the home. The large TVs in the two living rooms visited were constantly on, although with a low volume. That also gave the impression of an institutionalised feel. The manager has made some important improvements in a bedroom with plans to further improve it, gradually, by introducing softer wall finishes. There were some areas of damaged plaster, broken tiles and wallpaper in private and communal areas of the main house that should be made good. The inspector did not visit the flat. The levels of cleanliness in the home were satisfactory. Materials and equipment for the control of spread of infection were available and observed in use. Langley House DS0000060091.V301451.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35,36 The quality in this outcome group is good. Staff were clear about their responsibilities and those of others in the team. The team at Langley house are motivated to improve the service users wellbeing and to provide them with worthwhile life experiences. They have the knowledge and skills to bring about good outcomes for service users and are well supported by the homes policies and by their management. There is a training plan and plans to redress an imbalance in staff training. Staff members receive appropriate formal and informal support. EVIDENCE: The home employs staff in sufficient numbers. Flexible management approaches are used that are having positive impacts on staff absences. There is a senior staff vacancy and interviews were due to take place during the week. Supervisory staff members have specific areas of delegated management responsibility. The inspector had contact with all staff on duty and had private discussions with 3 supervisory staff, 3 care assistants and the manager. Three of the staff Langley House DS0000060091.V301451.R01.S.doc Version 5.2 Page 22 members spoken with were new. The new staff and their files evidenced good recruitment and vetting procedures, good induction both in -house and company induction in health and safety and specialist training such as LADAF and CPI. New staff and records evidenced that they were well supported by their individual supervisors and by the team. Staff members have formal supervision every two months. All staff spoken with thought highly of the management of the home and of their team. They enjoyed their work and were motivated by service users positive responses to their support plans and by opportunities provided for them. Incidents when service users where unhappy and hit out either to them or engaged in self-harm were described by staff as mostly minor. These were recorded. Staff worked to understand each person’s preferred ways. Staff felt part of the support plan of the person they were key-working with and had support in this task from supervisory staff. Staff were not placed “at the deep end” and new staff were given time until they were confident they could keywork service users. Observed practice evidenced warm relations between staff and service users. Service users were approached with respect and warmth. The staff files of new staff were inspected and evidenced that good recruitment, vetting, support and induction procedures had been followed in all cases. The training chart evidences a wide range of relevant training provided for staff. All new staff are now provided with comprehensive mandatory and specialist training. The chart provided by head office, however, show significant gaps for other staff. Some staff have had a great deal of training during the past 12 months but there are a handful that have had none and others have had less than the minimum 5 days per year required. The record show that about half of the staff have had significant specialist training in the last 12 months, many others have had it before that, and this, together with good leadership, appropriate staffing levels and support, translates in observed good outcomes for service users and in a motivated and positive workforce. The training area has now been delegated to one of the senior staff who is compiling a “at a glance” table showing when all staff have had training. The table should also show when updates are due. The managed forwarded the training plan for the year. NVQ training is provided after the specialist training. About ¼ of staff have NVQ qualifications. The training plan shows a list of staff registered for NVQ and suggests that the 50 target should have been met by January 2007. Langley House DS0000060091.V301451.R01.S.doc Version 5.2 Page 23 Staff and records evidenced formal supervision provided and staff indicated that they were well supported. Langley House DS0000060091.V301451.R01.S.doc Version 5.2 Page 24 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): 37,38,39,40,41,42 The quality in this outcome group is good. The home is ably managed and has a cohesive and positive team. There is an open management style. Systems are being developed that support staff in bringing about improved life experiences for service users. Relatives are encouraged to be involved in the care and support of service users and there are good relations and frequent contacts with families. Staff are aware of corporate policies which are made relevant for the home by the manager in discussions with them. Specific understanding of medication training should be provided for staff and the home should have records showing that all H&S topics have been covered by all of the staff with the necessary updates. Langley House DS0000060091.V301451.R01.S.doc Version 5.2 Page 25 EVIDENCE: Mark Coxwell was a registered manager in another home before coming to Langley House. The process of registering with CSCI for this service is now nearly completed. Mr Coxwell has substantial specialist experience to lead the team to the achievement of good outcomes. An open attitude and management style was evident. There is a complement of skills within the management team - that includes the deputy manager- of the home that brings about positive service users’ outcomes. Corporate policies and updates are sent by head office. Where necessary the manager adapts these to the needs of the home and examples were shown and discussed with the inspector. Policies are discussed with staff during meetings, supervision and training. The manager is a trainer with CPI, a BILD accredited organisation. Staff are now trained to used approved team physical intervention techniques, when necessary, as a last resort and as directed by the BM plan. Mr Coxwell was unsure if the company had specific insurance covering staff for physical interventions. He agreed to check this out with head office. Staff, the manager and records evidenced efforts made to work together with parents and advocate and to maintain them informed. Informal feedback is sought and there was evidence of parents input in the care and support of service users. Parents contacted Mr Coxwell on the day of the inspection to express their delight at a marked improved behaviour that has made the service user’s visit to the parental home much more enjoyable. The inspector discussed with Mr Coxwell informing stake holders of the outcomes of any formal quality assurance exercise. Mr Coxwell recently organised a tea party for all those involved with the home to provide an additional platform for feedback but had been poorly attended. This area could be reviewed with the provider’s representative during the monthly visits. Parents and others involved with the service could be consulted about a format that would interest them. The company provides training in all H&S topics but the training chart showed some gaps, as already mentioned in NMS 35. The fire log evidenced that all staff had received fire instruction and that safety checks were performed as appropriate. Checks for water safety and maintenance of energy and other systems were under service contracts and staff took relevant precautions such as running all taps frequently to prevent bacterial growth in the system. Langley House DS0000060091.V301451.R01.S.doc Version 5.2 Page 26 The medication area was well managed and staff followed the company’s policy and had their competences reviewed, however they should be provided with a medication course with the necessary updates. This has a been discussed already under NMS 20. The management of service users moneys was briefly discussed and staff observed accounting for moneys taken. This area is audited during regulation 26 provider visits and copies of these are sent to CSCI every month. Langley House DS0000060091.V301451.R01.S.doc Version 5.2 Page 27 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 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 3 26 X 27 X 28 3 29 X 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 4 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 3 3 x 3 3 3 3 3 2 x Langley House DS0000060091.V301451.R01.S.doc Version 5.2 Page 28 NA 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. 1. Refer to Standard YA9 Good Practice Recommendations Work to document up to date risk assessments for all service users now under way should be completed at the earliest opportunity. A specific course about the understanding of Medication should be provided for all staff that deal with medication, over and above the checking of competencies according with the home’s medication policy that is done at present. (Unmet from the previous inspection). Practical solutions should be found to make the communal areas of the main house more homely and to ensure prompt maintenance of areas in need of repair. The provider should ensure each staff member has at least five paid training and development days (pro rata) per year. (Unmet from the previous inspection). DS0000060091.V301451.R01.S.doc Version 5.2 Page 29 2. YA20 3. YA24 4. YA35 Langley House 5. YA39 You should ensure the results of service user surveys are made available to service users, their representatives and other interested parties. (Unmet from the previous inspection). You should ensure all staff have regular updates on all safe working practice topics - including general moving and handling, first aid and infection control - to promote safe working practices. (Unmet from the previous inspection). 6. YA42 Langley House DS0000060091.V301451.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 Langley House DS0000060091.V301451.R01.S.doc Version 5.2 Page 31 - 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. 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