Inspection on 13/02/07 for Lawn House Care Home

This inspection was carried out on 13th February 2007.

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

The inspector found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Lawn House Care Home 12/03/08

Lawn House Care Home 22/11/05

Lawn House Care Home 21/07/05

Lawn House Care Home 17/02/05

Lawn House Care Home 07/10/04

Similar services:

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

Pinta

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

CARE HOME ADULTS 18-65 Lawn House Care Home 4 Lawn Road Portswood Southampton Hampshire SO17 2EY Lead Inspector Ms Sue Kinch Unannounced Inspection 13th February 2007 10:30 Lawn House Care Home DS0000037558.V323459.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 Lawn House Care Home DS0000037558.V323459.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. Lawn House Care Home DS0000037558.V323459.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lawn House Care Home Address 4 Lawn Road Portswood Southampton Hampshire SO17 2EY 02380 584911 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) Park Care Homes (No 2) Ltd Care Home 10 Category(ies) of Learning disability (10), Mental disorder, registration, with number excluding learning disability or dementia (10) of places Lawn House Care Home DS0000037558.V323459.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Service users may be accommodated between 18 - 60 years of age One named service user may occupy a downstairs bedroom previously unregistered, as agreed. 22/11/05 Date of last inspection Brief Description of the Service: Lawn House is a large detached home which provides long term residential care for up to 10 adults who have a learning disability. The home is close to local shops and amenities, there is also good public transport links to Southampton city centre. Lawn House is run and owned by Park Care Homes (No2) Ltd of Craegmoor Healthcare who provides services to vulnerable children and adults across England and Wales. The accommodation is organised over two floors with a third floor that is not used for service user access. There are 10 single bedrooms all with ensuite WC, shower or bath. Three bedrooms are on the ground floor and seven on the first floor. The ground floor, walk in shower, entrance lobby and hall leading to the kitchen. The dining room leads to the lounge area where there are French windows onto the garden that can accommodate people who have mobility difficulties. To the rear of the lounge is a small activities area. There are four shared toilets for service users, one bathroom and one wheelchair accessible shower. The home has stairs and a shaft lift to the upper areas of the accommodation. There are also two small mezzanine areas. Staffing is provided 24 hours a day, with sleep-in staff at night. The basic fee for a week is £725.63 but the actual fee charged depends on the assessed needs of individual service users and levels of support required. Lawn House Care Home DS0000037558.V323459.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. At this inspection all key standards were assessed. It was unannounced and was completed by one inspector over 5.75 hours. Five service users, four staff members and a visitor to the home were spoken with. Care practices were observed. A partial tour of the home was made with some of the service users. The ground floor shared areas and four bedrooms were seen. Some of the homes records and policies and procedures were also viewed. Information was also obtained by reviewing the service file held by CSCI. The pre inspection questionnaire was not returned in time. Following the site visit further information was obtained from the manager during a telephone call and from information sent to CSCI. What the service does well: What has improved since the last inspection? What they could do better: There are areas for improvement identified in the report but progress towards these has been noted and the manager spoke of plans to address most of the issues raised. Regular reviews of care plans and risk assessments must be more rigorous. Evidence of how service users money is managed needs to be Lawn House Care Home DS0000037558.V323459.R01.S.doc Version 5.2 Page 6 more readily accessible to staff and service users. A routine system of staff supervision needs to be fully established. Elements of the environment need improvement and a requirement has been made about the external décor at the front of the house because no improvement had been made. In addition a requirement has been made about making movement about the home easier for wheelchair users. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Lawn House Care Home DS0000037558.V323459.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Lawn House Care Home DS0000037558.V323459.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Systems are in place to assess the needs of service users before admission to the home. EVIDENCE: There was sufficient written and verbal evidence that the needs of the most recently admitted service user had been assessed before being admitted to the home. In addition the service users needs have continued to be reviewed regularly by the home in conjunction with the care manager since the admission and there was evidence during the inspection of aspects of the service that had been altered or adapted to meet that persons needs. This included alterations to the bedroom and staffing level. A discussion was held with the service user and visitor who thought that the home was meeting the service users needs. Lawn House Care Home DS0000037558.V323459.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from their needs and wishes being reflected in their care plans and risk assessments and from care provided with consultation and support with decision-making. However, this is would be improved by more consistent reviewing to ensure that choice continues and needs are met. EVIDENCE: Service users are aware that there are care plan records about them in the home and those asked said that they had talked about the care they need with the staff. Staff agreed and said that the care plans reflected the care needed. A sampled of care issues discussed with service users or staff during the inspection were mostly addressed in the care plans. A sample of care plans containing a substantial amount of information for each service user was viewed. There was some evidence of service user involvement. In the three care plan files viewed information recorded was based on their needs and wishes. Lawn House Care Home DS0000037558.V323459.R01.S.doc Version 5.2 Page 10 Attention has been given to individual risks to service users and guidance is recorded for assisting staff to minimise those risks. However, these risk assessments were in need of reviewing as some required to be reviewed quarterly had not been reviewed since May 06. The information stored also included the use of person centred planning tools completed in 2005, identifying goals for individuals, but there was not enough evidence that these have been monitored and reviewed in the files viewed. The review date for one service user was shortly after the inspection. For one other the review date had passed. The manager stated that the review for the third person had been completed during the week before the inspection. The manager said that all service users were gradually being reviewed. This will be monitored in future visits to the home. Members of staff said that they have access to and read the care plans regularly and were able to check information as needed. Where risk assessments exist for a particular area of care it would be advisable to state this in the actual care plan to help staff to find information more quickly. The member of staff spoken to about this thought it might help. Service users are encouraged to be involved in the running of the home and spoke of involvement in tasks such as shopping cooking and cleaning. A rota is in place but is applied flexibly so that service users still have choices. One person prefers to help with peeling vegetables and cutting the grass and this is supported. Confidentiality is promoted in the home. Files storing service users information are kept in a locked cupboard and staff were careful to ensure that these were returned promptly. However, although staff said that medication sheets are stored securely with the medication they were found on the radiator in the dining room. Staff addressed this when it was pointed out. A personal care routine was posted on the ground floor bathroom wall. The manager agreed that it should not be there. Lawn House Care Home DS0000037558.V323459.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are offered a range of activities based on their personal preferences and including use of the local community. They will benefit further from increased involvement in financial arrangements. Service users enjoy a healthy range of food provided. EVIDENCE: Service users are provided with a range of activities and things to do. Six service users were out at the start of the inspection. One was out with a support worker, two were shopping with a staff member and others were at day centres. Support is given regularly to pursue interests and evidence of this was seen in service users rooms and in the small recreation area at the back of the lounge. Service users spoke of a range of activities in the home and using the local community. External activities service users spoke of included swimming, bowling, going to the pub or cinema, shopping, and visiting friends. Activities mentioned at the home were watching TV, listing to music, discos, Lawn House Care Home DS0000037558.V323459.R01.S.doc Version 5.2 Page 12 BBQs, sitting in the garden, helping with jobs, friends visiting, collecting models, and watching football. A member of staff said that there are enough staff working to be able to support service users out of the home for planned and spontaneous activities. It was noted that service users rooms are individualised reflecting their preferences and interests. One service user particularly spoke of the support given from staff to have the things that they wanted and said that they enjoyed being in their room and had enough to do. Another service user also felt able to pursue personal interests and had plenty to do. Staff said that one person was difficult to motivate but work was taking place to support this. Staff are mindful of the rights of service users to make decisions. This is supported by conversations held with two staff members about some of the restrictions placed on service users such as smoking and access to the kitchen at night. Both staff members were aware of service users rights and their own roles in negotiation over these issues. An example of this was overheard during the inspection and the member of staff was patient and supportive of the service user. The manager intends to increase the involvement or control of some service users over aspects of their lives such as in finances. The manager said that some service users are involved in collecting their money and then manage it themselves. One staff member reported to be unable to access other service users individual finances in the absence of the manager and therefore was currently unable to support some service users with budgets. This will be monitored at a future inspection. Support is given with relationships and a statement about visiting was viewed. A service user spoke of being supported by staff to visit a friend and to have friends at the home. Service users are involved in various activities related to food. At the start of the inspection two service users had gone shopping for groceries with a member of staff. When they returned one of the service users said that they had enjoyed doing it and although they had gone with a list they said that they could buy additional items as well if wanted. During lunch a conversation was held with staff and service users about how food is organised in the home. Service users said that they could have foods that they liked and that they had helped with the menus and cooking. Various choices had been made for lunch. Service users said that they were given a range of foods with alternatives if food on the menu was not liked. Records are held of food provided so that monitoring can take place if necessary. Weight is monitored for some service users and particular needs were noted in some of the care plans. Lawn House Care Home DS0000037558.V323459.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are supported to maintain good health and receive positive personal care. Service users benefit from trained staff who deal with medication competently. EVIDENCE: Care plans seen included details of the support needed in personal and care. Service users asked about this confirmed that they had regular help from the staff for this and all spoken with appeared to be dressed comfortably and in clothes that they liked. Personal care was discussed with one service user and support worker who confirmed that help was given with teeth and nails. They also pointed out that the ensuite shower area had been adapted to suit that person. Two other service users, who prefer showers have baths in their en suite facilities and have to go to another floor for showers. Health care needs and support required are also documented in the care plans and records are held of the visits made to various professionals and specialists for assessment and treatment. Lawn House Care Home DS0000037558.V323459.R01.S.doc Version 5.2 Page 14 Medication practices in the home were discussed with one member of staff who explained elements of the homes system. Medication is stored securely, some in a monitored dosage system and lists of prescribed medication are held in care plans as well on the computerised medication sheets. The member of staff described the procedure for medication and this was in line with national guidance. Some checks were made of the stocks against the administration records and there was sufficient evidence that service users prescribed medication is given to them regularly. The records were signed and no gaps were seen. The staff member said that training in medication had been received and there was a certificate for this member of staff and others in the training file. All service users asked said that staff gave them their medication regularly. Lawn House Care Home DS0000037558.V323459.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users feel able to raise issues and are confident that they will be listened to but would benefit from more accessible information about how to make a complaint. Members of staff are trained to be aware of their role in adult protection. EVIDENCE: The manager reported that formal complaints had not been made to the home in recent months but that a log book is available for this. The complaints procedure is posted on the wall in the front hall but is in small print, without pictures and is not easy to reach. Service users asked were able to say what they would do if they had a complaint; felt able to talk to relatives, care managers, staff or the ‘boss’. Service users did agree that staff listened to them and evidence of this was noted during the visit to the home. This included people who used mostly non-verbal communication or had speech difficulties. Two service users also stated that they had ‘no complaints’. Elements of adult protection were discussed with some staff. One confirmed that a Criminal Record Bureau (CRB) check and a Protection of Vulnerable Adult (POVA) check had been completed before employment was commenced and that they had received training in adult protection including whistle blowing. Another staff member had also had received training and would report concerns. This person was not clear about roles in investigation but said that they would consult management if an allegation were made. Guidance regarding adult protection is posted on walls in the home. However, it was Lawn House Care Home DS0000037558.V323459.R01.S.doc Version 5.2 Page 16 unclear that all staff, who may be responsible for the home in the manager’s absence, are clear to the limits of their role. A check of the money held for service users and related records were locked away by the manager and were not accessible during the visit to the home. Therefore accuracy in managing their money could not be checked. Involvement of staff in this is referred to in the lifestyle section. Measures need to be taken to ensure that records can be checked during inspections. During the inspection it was noted that an incident had previously occurred when a service user left the home alone and was brought back by the police. This was recorded in a resident’s file but was not reported to CSCI under Regulation 37 of The Care Home Regulations 2001. This occurred before the new manager was in post. In discussion the new manager confirmed knowledge of the reporting process and this was evidenced with a recently reported incident. Lawn House Care Home DS0000037558.V323459.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is clean, comfortable and homely however work on the front of the house is outstanding and must be addressed. Further improvements could also be considered for improved access by all service users. EVIDENCE: The inspection report of 21st July 2005 reported of plans to refurbish the front aspect of the home. There ware several areas of flaking paintwork. This has yet to be rectified in order to consistently meet the standards, and to avoid the home presenting a negative image of the people living there. The manager was not aware of any specific plan to address this and a requirement has been made. The internal areas of the home seen during the inspection were mainly decorated to a satisfactory level although some monitoring and improvement will be needed due to wheelchair damage to paintwork. It was noted in the health section of this report that adaptations have been made for one person Lawn House Care Home DS0000037558.V323459.R01.S.doc Version 5.2 Page 18 in their bedroom. However, consideration is also needed to the width of a doorframe which one service user in a wheelchair struggled to negotiate independently when entering a room. A requirement has been made about this. Consideration should also be given to service users needing showers instead of baths in their en suite facilties. A staff member asked about maintenance was able to confirm that a worker who is in the home twice a week, completes it regularly. A book is used to record problems was viewed and tasks are signed off when completed. A member of staff also confirmed that checks are made weekly of some aspects of the home and showed an example of the hot water temperatures being regularly checked in bedrooms. Service users are provided with comfortable surroundings and have homely rooms furnished with suitable furniture and decorated with evidence of personal touches being encouraged. All service users spoken with about their rooms said that they were satisfied or happy with them. One person did say that they would like a chair. The home is clean and service users said they are involved. Arrangements were flexible. Safeguards are in place to maintain infection control. It was discussed with a member of staff who had received relevant training and gave examples of the implications for staff. Staff were using protective clothing such as disposable gloves, aprons and hair coverings (in the kitchen). Signs were posted in various places about the benefits of regular hand washing. Lawn House Care Home DS0000037558.V323459.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35,36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users appreciate the friendly, caring staff members who are provided in sufficient numbers. They are mostly safeguarded by the organisations recruitment procedures although some improvement is needed. Service users are supported by designated and increasingly trained key-workers but frequency of supervision needs improvement. EVIDENCE: Staff are provided in the home throughout the day and night to support planned and spontaneous activities. A member of staff said that there is always a minimum of three staff on duty before 8pm. A minimum of two staff are always in the home and others are able to support people in the community. The rota supported this. The manager spoke of recent negotiations to enable the home to continue to meet the needs of one service user whose increased needs had affected the homes ability to also meet other service users needs. Negotiations had been successful and additional hours are provided daily for that person – including the day of the inspection. This is under regular review with the care manager. Lawn House Care Home DS0000037558.V323459.R01.S.doc Version 5.2 Page 20 Consistency was discussed with staff members who said that a number of agency workers had been used but those currently providing support were regular and known to the service user. The manager reported to have been seeking alternative ways of providing this support to improve continuity. Staff members spoken to during the inspection were clear about their roles and responsibilities. They said that they had induction and training in areas such as food hygiene, first aid, moving and handling and all areas considered as mandatory by the organisation. The manager said that the new staff members were following the induction process and that it was in line with national guidance for services for people with learning disabilities. There are training records in the home and a large chart of training completed. The manager spoke of other in-house, more client specific training that staff had received. The manager said that her plans included ensuring all staff are up to date with required training and then to look further at training in relation to special needs of the service users. A sample of recruitment records were viewed and were found to be in place with most relevant checks completed such as POVA First, CRB and references before the recruitment of staff. However more details were needed for one person whose employment history was incomplete. This must be checked out. The manager also has a system in place for checking details of agency staff. The manager recognises that formal supervision of staff needs to be developed. She has begun to delegate more responsibility and wishes to involve staff in more aspects of the work whilst increasing their knowledge. However, there was not enough written evidence that staff are given individual supervision routinely although most staff spoken to said that they were supported and could get guidance when needed. The manager said that both seniors had received supervision training and after skills had been refreshed they could share the role with her. Lawn House Care Home DS0000037558.V323459.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The service really needs a registered manager in post to ensure matters related to quality of the service are implemented fully to benefit service users. EVIDENCE: The home has recently experienced another change in management and has not had a registered manager for over a year. Some systems consequently have not yet been fully updated, such as care plans and risk assessments, or maintained such as staff supervision and staff meetings, but the manager had plans to continue to address this. The current manager recruited in the autumn of 2006, has experience of working with adults with learning disabilities and has previously been a registered manager. She reported that she has registered to obtain the registered manager’s award but has delayed in applying to register as manager of the home. Lawn House Care Home DS0000037558.V323459.R01.S.doc Version 5.2 Page 22 Staff and service users consider the manager to be approachable. Service users spoken with felt able to talk to the manager and would speak to her if a problem arose. Most staff members spoken to felt fully supported by the manager. One of the four staff spoken with about this had not had supervision for several months. That member of staff would like more guidance. Quality control was discussed with the manager. This in place but not yet fully effective as some of the systems mentioned in sections above were not yet fully up to date. She said that there is a quality monitoring system in the home and that reports are sent to the organisation following audits on a monthly basis. In addition service users are asked about their care plans every other month. However, she agreed that the home does not currently have an improvement plan that is shared with service users and was advised to address this. Attention is regularly given to health and safety and there were several indications of this during the inspection visit. No obvious health and safety hazards were noted. Appropriate signs are posted through out the home showing where fire exits are. One service user explained the process to follow if the fire bells were set off. The description given matched the record held by the home for that person. Staff members were wearing hair protection and using colour coded chopping boards in the kitchen. Hazardous substances were securely held. Staff spoke of receiving health and safety training and were aware of elements of infection control. They were also aware of storage of hazardous substances and are involved in monitoring the environment. Training for staff is provided in topics such as first aid, food hygiene and moving and handling and the manager said that all such training deemed as mandatory by the organisation is also monitored regulalrly. Evidence of such training was noted in the two training records viewed. The manager also said that servicing of the equipment was regular and when requested, promptly sent a sample of certificates to CSCI to demonstrate this. Lawn House Care Home DS0000037558.V323459.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 x 2 3 3 x 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 3 ENVIRONMENT Standard No Score 24 2 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 x 34 2 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 x 2 3 LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 2 x 2 x x 3 x Lawn House Care Home DS0000037558.V323459.R01.S.doc Version 5.2 Page 24 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 YA9 Regulation 13(4)(a) Requirement Timescale for action 13/05/07 2 YA24 23(1)(a) 23(2)(b) 3 YA24 23(2)(a) 4 YA36 18(2) Service users individual risk assessments must be reviewed regularly to ensure that adequate support is provided. The front of the home must be 13/05/07 repaired and repainted and regularly maintained to ensure that the image of service users is not at risk. Adaptations must be made to 13/04/07 the physical environment so that service users using wheelchairs are able to manoeuvre without obstruction. Care staff must have regular 13/05/07 recorded supervision to enable them to meet service users needs. 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 Lawn House Care Home DS0000037558.V323459.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Lawn House Care Home DS0000037558.V323459.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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