Inspection on 03/10/06 for Laura House

This inspection was carried out on 3rd October 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 found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Laura House 13/01/09

Laura House 16/02/06

Laura House 06/10/05

Laura House 02/02/05

Laura House 23/09/04

Laura House 18/03/04

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 Laura House Belmont Terrace Totnes Devon TQ9 5QB Lead Inspector Wendy Baines Unannounced Inspection 3rd October 2006 10:00 Laura House DS0000003739.V302863.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 Laura House DS0000003739.V302863.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. Laura House DS0000003739.V302863.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Laura House Address Belmont Terrace Totnes Devon TQ9 5QB 01803 866541 01803 847771 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) Robert Owen Communities Mrs Therese Annette Timberlake Care Home 16 Category(ies) of Learning disability (16), Physical disability (16) registration, with number of places Laura House DS0000003739.V302863.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th February 2006 Brief Description of the Service: Laura House is a care home registered to provide care for sixteen service users with a learning disability who may also have a physical disability. It is situated close to the centre of Totnes, which is reached via steep roads. Laura House is a detached, modern, purpose- built building, divided into three separate flats or houses. Houses one and two accommodate service users with higher levels of needs and/or a physical disability. These are on one floor, with a full passenger lift to access other areas. House Three is a semi-independent unit for four people with accommodation on two floors, and its own external entrance. Service users are accommodated in single rooms. Each house has its own lounge, dining room, kitchen and adapted bathing facilities. Fifteen people only now live in Laura House, as two bedrooms have been converted to one to provide more spacious accommodation for a wheelchair user. Outside there are two enclosed lower ground floor patio areas at the rear, accessed from houses two and three. The premises are built on a sloping site and access to the grassed area below the patios is via a steep ramp. There is limited parking at the front of the building Laura House DS0000003739.V302863.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report is a summary of a cycle of Inspection activity at Laura House since the last inspection visit. To help CSCI make decisions about the home the Provider gave us information in writing about how the home is run; any documents submitted since the last inspection were examined along with the records of what was found at the last visit; two site visits totaling 12 hours were carried out with no prior notice being given to the home as to the date and timing; discussions were held with the Registered manager and staff on duty; various records were sampled, such as care plans and risk assessments; questionnaires were sent to a sample of staff ; and a tour was made of the home and garden; time was spent with the service users and the inspector was able to talk with, and observe the staff on duty. In addition a sample group of residents were selected and their experience of care was tracked through records and discussions with staff and management from the early days of their admission to the current date, looking at how well the home understands their needs and the opportunities and lifestyles they experience. Where possible time was then spent with these service users, and questionnaires were sent to their care managers and other specialist services where appropriate. Questionnaires were sent to 10 members of staff, and a sample of service users but only two staff questionnaires were returned. Any feedback received following publication of the report will be included in the next inspection report. Feedback was also received from the Specialist Learning Disability Service, Speech and Language department and Consultant clinical psychologist involved with the home. Feedback included comments such as, “ Laura House provides a responsive, caring, respectful approach to people as individuals” (Speech and Language dept) This inspection approach hopes to gather as much information about what the experience of living at the home is really like, and to make sure that service users views of the home forms the basis of this report. Laura House DS0000003739.V302863.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? Since the last inspection information available to staff regarding the positioning and moving of service users with profound physical disabilities has been improved. Photographic information is now available, which ensures that staff Laura House DS0000003739.V302863.R01.S.doc Version 5.2 Page 7 are consistent and aware of service users choices and preferences about how care is delivered. Staff have started to attend training relating to the new, revised food hygiene standards “ Better Food, Better Business”, and these procedures are now being implemented within the home. Following an Occupational Therapy assessment adaptations have now been completed within the bathroom and bedroom of one service user who had chosen to move into the more independent unit within the home. The service user said that she was happy with the changes that had been made. 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. Laura House DS0000003739.V302863.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 Laura House DS0000003739.V302863.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): 1,2,3,4,5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the home. Current and prospective service users are provided with sufficient information about the home to help them make an informed choice about where they live. The homes admissions process ensures that prospective service users know that if they move into the home their needs will be met. EVIDENCE: The home had a statement of purpose and service user guide, which described the environment and services available. Information about the home was also available in signs, symbols and on videotape. One service user had moved into the home since the last inspection and records were tracked to establish the quality of the homes admission procedure, and the experience of all those involved in the move. Following referral a thorough pre-admission assessment had been completed by the home to confirm whether or not the individuals needs could be met. The service user then visited the home on several occasions and a trial placement was agreed. The pre-assessment information was used to develop an initial care plan for the home and following admission a written contract was agreed between the home and service user. Since the admission the home had received a letter of thanks from the family highlighting how supportive staff had been and how well their son had settled into his new accommodation. Laura House DS0000003739.V302863.R01.S.doc Version 5.2 Page 10 As part of the admissions process the home had also supported the new service user to maintain advocacy involvement to support him to make decisions about his care. Any restrictions, which may be imposed due to agreements within Laura House or relating to the individuals needs, had been agreed and recorded prior to admission. Laura House DS0000003739.V302863.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): 6,7,9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the home. The home has a clear and consistent care planning system in place to adequately provide staff with the information they need to satisfactorily meet service users needs. Service users are encouraged and enabled to make choices and have control over their lives. EVIDENCE: A sample group of service users were selected and their experience of care was tracked through records and discussions with staff and management from the early days of their admission to the current date, looking at how well the home understands their needs and the opportunities and lifestyles they experience. As part of this process the inspector looked at service users care plans and other daily records relating to the individual. Service user care plans had been completed and covered all aspects of personal, social and healthcare needs they also highlighted short and long term goals. Where appropriate service users had a copy of the plan in their Laura House DS0000003739.V302863.R01.S.doc Version 5.2 Page 12 room and this was available in a range of formats dependent on the needs of the individual. The detail within care plans reflected the level of care required and where needs were more complex step- by- step guidance was available to staff to ensure consistency. Much consideration had also been given to ensuring service users make choices about their care and records also included a section called, “ My history, My personality, and how I like to be supported” Staff spoken to said that this information is completed with the individual and staff that know them well, and is reviewed as part of the care plan process. Staff demonstrated a good understanding of service users communication needs and this information was clearly documented. A range of communication aids were available around the home to support service users including specialist equipment, signs, symbols, daily planners and photographs. The home regularly liaises with the specialist speech and language department and feedback from these services was positive. Records and discussion confirmed that service users are supported to access independent advocacy services. One service user was being supported by an advocate to help make decisions about accommodation plans for the future. Throughout the inspection staff were observed using their knowledge and skills to encourage and support service users to make choices and have control over their lifestyle. Risk assessments had been completed for activities inside and outside the home. Records and discussion confirmed that service users who are more independent are able to make choices about their daily routines but are given advice and guidance from staff about how to keep safe. Records confirmed that key workers meet regularly, and care plans are reviewed at least annually or every six months and external agencies are kept informed about any significant changes. Laura House DS0000003739.V302863.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): 11,12,13,14,15,17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the home. Service users are encouraged and supported to participate in community, social and leisure activities and to maintain contact with family and friends. The meals in the home are good offering both choice and variety and catering for special dietary needs. EVIDENCE: The atmosphere in the home was warm and welcoming. Several service users were getting ready for planned day care arrangements and other social, leisure activities. Other service users were enjoying a leisurely breakfast and staff were preparing for activities for individuals in the house. Within the home much consideration has been given to creating a stimulating and homely environment. Some service users were spending time in their bedrooms with sensory equipment, soft lighting and relaxing music. Care plans and daily records included information about independent living skills, social/ leisure opportunities, community integration and relationships. Laura House DS0000003739.V302863.R01.S.doc Version 5.2 Page 14 Any regular arrangements were recorded as part of a weekly planner. A minibus is available and service users are also encouraged and supported to use public transport if possible. Service users attend a range of leisure, work and educational opportunities inside and outside the home. These include; day trips, college courses, cinema, swimming, hydrotherapy, music sessions and holidays. Activity planners were available in a range of formats dependent on the communication needs of the individual. Care plans included physiotherapy, reflexology and hydrotherapy sessions for service users with more complex care needs. Service users who live within the semi-independent part of the home said that they have a “ busy” social life and usually make their own arrangements with support from staff if necessary. Feedback from the specialist Learning Disability service included; “ It is very sociable and the service users are provided with a very lively and age appropriate social life and similar age staff” Service user records contained information regarding friends, family and relationships. Birthdays and other special occasions were recorded and staff said that they would support service users to send cards, letters and maintain these contacts. There are no restrictions on visitors and staff spoken to who support service users with complex care needs said that the involvement and inclusion of family members is positively encouraged. Throughout the day staff were observed knocking on service users bedrooms and responding sensitively and respectfully to their requests. Discussion took place with the Registered Manager regarding the use of ‘baby’ alarms to monitor some service users whilst they are in their bedrooms. It was not evident that this arrangement had been agreed as part of a multi-disciplinary process or if the use of them was reviewed to ensure that they continue to be required. In addition discussion took place about service user bedroom doors and the use of window openers that had been fitted when the home was built. Staff spoken to agreed that although this facility was rarely used this could be intrusive and may impose on service users privacy. A written weekly menu was available within each house, which confirmed that service users are offered a well-balanced and varied selection of meals. When possible service users were involved in choosing meals, shopping and food preparation. Snacks and drinks were available throughout the day and mealtimes were flexible and relaxed. Records confirmed that there were some special dietary requirements and this information was clearly documented. Staff spoken to were aware of these guidelines and daily charts relating to diet/ weight were found to be up to date. Laura House DS0000003739.V302863.R01.S.doc Version 5.2 Page 15 Laura House DS0000003739.V302863.R01.S.doc Version 5.2 Page 16 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the home. The health needs of service users are well met with evidence of good multidisciplinary working taking place on a regular basis. EVIDENCE: Service user records included information regarding personal and healthcare needs. The information was detailed and included daily routines and personal preferences about how care is delivered. Some service users have profound physical, learning and communication difficulties and this level of need is reflected in the detail of information available to staff. Moving and handling plans were seen and in some cases photographs had been taken to ensure that staff could fully understand how service users with profound physical difficulties needed and preferred to be positioned. It was evident through discussion that staff recognised the importance of consistency particularly for service users with complex care needs and communication difficulties. Examples were given of documented guidelines for one service user who needs medication to be administered within a quiet and relaxed environment. Staff spoken to were familiar with these procedures. Laura House DS0000003739.V302863.R01.S.doc Version 5.2 Page 17 A range of daily charts are completed and handover meetings and daily diaries are used to monitor any changes in an individuals health. Feedback from the specialist Learning disability services confirmed that the home regularly liaises with outside agencies to support their role and to request advice and support. Positive comments were received stating that some aspects of the care provided is ‘ excellent’ but that at times there is a lack of consistency with the systems that work well. This feedback was discussed with the Registered Manager who recognised that the importance of consistency needed to be an on-going training area for all staff. Staff were observed supporting one service user who was feeling unwell. The staff worked hard to create a comfortable and relaxing environment and spoke to the service user gently and respectfully ensuring that plenty of 1:1 support was available. Service user records included an ‘ OK health check’ which identified specific needs and arrangements for routine health appointments. Medication records were available for each service user. Records inspected were found to be in good order and up to date. Detailed information was available regarding the individuals’ health, current medication, reason for taking and any possible side effects. All medication was found to be safely stored with a procedure for regular checks to ensure that medication is up to date and returned to the pharmacy when necessary. All staff that administer medication receive regular training and one senior member of staff spoken to was due to attend an advanced course in the administration and handling of medication in care homes. Service users who have been assessed as being able to self-medicate are supported to do so and have a lockable storage facility provided. With the agreement of the service user this medication is checked on a weekly basis. Laura House DS0000003739.V302863.R01.S.doc Version 5.2 Page 18 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the home. The Provider responds to complaints promptly using the homes complaints procedures, and takes seriously any concerns made in relation to the home and service users. Staff have a good understanding of Adult Protection issues, which protects service users from abuse. EVIDENCE: The home had a written complaints procedure and this was also available in a picture/symbol format. Since the last inspection there had been 4 complaints made direct to the home and all information had been documented and were made available for inspection. One complaint had been made by an outside agency regarding clothing worn by service users during outside activities. The home responded to this concern using their complaints procedure and had taken into consideration the issues raised. A further complaint had been made by a neighbour regarding the mini- bus and again this had been dealt with appropriately and resolved. Two further complaints related to individual service users and records confirmed that the home had liaised with all agencies concerned to address and resolve the issues. Daily records, Person-centred plans, hand-over meetings and service user meetings are all used to ensure that service users can express their opinions and any concerns can be monitored, and addressed. Laura House DS0000003739.V302863.R01.S.doc Version 5.2 Page 19 There is an adult protection procedure and the locally issued Alerters guide for staff reference. Staff receive training in issues relating to abuse and adult protection. Records and discussion confirmed that clear guidelines are available for staff to deal with and manage episodes of difficult behaviour and/or aggression. Risk assessments and records included lone working and missing person’s procedures. The home had clear and consistent procedures in place for the protection and management of service users finances. Information regarding service users skills and needs regarding money is recorded as part of their care plan. All service users have their own bank accounts and facilities for safe storage of money and personal belongings. A record of all expenditure is kept with receipts where possible. For service users who are more independent risk assessments are completed to establish any support required to protect the individual from financial abuse. Laura House DS0000003739.V302863.R01.S.doc Version 5.2 Page 20 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): 24,25,26,27,28,29,30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the home. The standard of the environment is good providing service users with an attractive, homely and safe place to live. EVIDENCE: The premises are purpose built to cater for service users with a range of needs, from those who are semi-independent to those with profound physical, learning and communication difficulties. The home has been arranged into three separate units/houses each with their own lounge/dining area, kitchen, bathrooms/ toilets and patio area. The unit for service users who require minimal support also has a separate entrance. There are two patio areas but outside space is limited. Discussion took place with one member of staff who is working with a student occupational therapist to plan a sensory garden for one of the houses. Most of the bedrooms were seen during the inspection and all were found to be well- decorated and contained essential furnishings and plenty of personal items to reflect the individual’s interests and personality. Consideration had been given to making the environment stimulating, interesting and homely. Signs, symbols and photographs have been used to Laura House DS0000003739.V302863.R01.S.doc Version 5.2 Page 21 assist service users with communication difficulties and several individual bedrooms and bathrooms contained a range of sensory equipment. A range of equipment is provided for service users with physical disabilities, including assisted baths, overhead tracking hoists, mobile hoists, slings, walking aids and wheelchairs. Staff had been trained in the use of this equipment and records confirmed that the home had a contract for the regular maintenance and repair of all equipment in the home. All parts of the house were found to be clean and hygienic. Wash hand basins, gloves and other cleaning equipment were available to ensure the control of infection. Since the last inspection adaptations have been completed in one bathroom and bedroom for a service user who requested a move into the more independent part of the home. Laura House DS0000003739.V302863.R01.S.doc Version 5.2 Page 22 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the home. Staff are sufficient in number, and have the skills and attitudes to ensure that service users needs are sufficiently met. The manager is supported well by senior staff in providing clear leadership throughout the home with all staff demonstrating an awareness of their roles and responsibilities. EVIDENCE: Staff demonstrated a good awareness of service users needs and were very familiar with care plans and specific guidelines for providing support. Throughout the inspection staff were observed interacting with service users on a one to one basis and in groups. There was a good rapport between service users and staff and the atmosphere in the home was happy and relaxed. The Registered Manager was present during the inspection and the senior staff who were overseeing the day- to- day running of each unit were very familiar with systems and procedures and were able to provide clear information regarding the home and individual service users. Laura House DS0000003739.V302863.R01.S.doc Version 5.2 Page 23 Each of the three separate units/ houses within the home has their own staff team although staff will work within other units to cover staff shortages and sickness. The staffing rota for each house was available for inspection. The number of staff is dependent on the level and type of support needed and staffing levels are kept under review. Agency staff are used when necessary and those spoken to said they were very familiar with the home and the records and systems ensured that they had clear information about their role and needs of each service user. Staff training records were seen which confirmed that staff undertake a range of in-house and external training and this is regularly up dated. Since the last inspection staff have attended; Total communication, Epilepsy, First aid, Moving and handling, and Adult Protection training. Arrangements were in place for staff to have updated training in Medication and Infection control. The Registered manager said that the home has good links with the health services and Specialist Learning Disability team. This was confirmed within feedback from these agencies. A sample of staff records were seen and confirmed that the homes recruitment procedure is robust and ensures the protection of service users. The home has a mentor/buddy system for all new staff during the induction period. Staff spoken to said they felt well supported by other team members and management. Key-worker and team meetings take place on a regular basis, and the rota allows for a shift handover to discuss the daily events. Records confirmed that formal supervision takes place every 6-8 weeks and this information is documented. Laura House DS0000003739.V302863.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): 37,38,39,42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the home. Service users benefit from an open, inclusive and positive style of management. The manager is supported well by the senior staff in providing clear leadership throughout the home with all staff demonstrating an awareness of their roles and responsibilities. EVIDENCE: The Registered Manager Mrs Theresa Timberlake is a qualified nurse and has completed the Registered Managers award. The key management responsibilities in the home are shared between the Registered manager, two deputy managers, and senior support staff in each unit. Laura House DS0000003739.V302863.R01.S.doc Version 5.2 Page 25 Throughout the inspection all staff demonstrated a good understanding of their role and were able to give clear information about policies, procedures and the needs of service users. The atmosphere in the home and between staff and management was open, positive and supportive. There are regular meetings with service users and staff where any issues concerning the home can be discussed. There is also a comments box situated within the entrance hall, which is emptied regularly and any issues are discussed within team meetings. The manager said that the home undertook a full questionnaire 2 years ago and requested feedback from service users, staff, relatives and other agencies. However, there is not a system for gathering this feedback on a more regular basis. All records relating to service users was up to date and well documented. Records relating to health and safety issues, such as risk assessments, the accident/injury book, and fire log were up to date. Training records confirmed that all staff attend mandatory health and safety training and this is regularly updated. Since the last inspection staff had attended training relating to the new food hygiene standards “ Safer Food, Better Business” and these procedures were being implemented in the home. Records were available to confirm that all equipment, the lift and mini-bus are regularly serviced. Laura House DS0000003739.V302863.R01.S.doc Version 5.2 Page 26 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 4 3 3 4 4 5 3 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 3 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 X 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 3 3 X 3 3 3 X X 3 X Laura House DS0000003739.V302863.R01.S.doc Version 5.2 Page 27 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. 1. Standard YA16 Regulation 12-4.a Requirement The Registered Person shall make suitable arrangements to ensure that the home is conducted in a manner, which respects the privacy and dignity of service users. (Reg 12 4.a) - Review the use of monitors. I these facilities continue to be used these arrangements must be documented and reviewed as part of the individuals care plan. - The use of window openers should cease and risk assessments reviewed to consider the needs of service users who require close monitoring. Timescale for action 01/01/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. Laura House DS0000003739.V302863.R01.S.doc Version 5.2 Page 28 No. 1. Refer to Standard YA39 Good Practice Recommendations The Registered Provider should consider ways of developing the homes quality assurance systems. The home should regularly review aspects of its performance through a good programme of self-review and consultations, which include seeking the views of staff, service users, relatives and other agencies. Laura House DS0000003739.V302863.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Laura House DS0000003739.V302863.R01.S.doc Version 5.2 Page 30 - 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!