Inspection on 15/01/07 for Lawrence House

This inspection was carried out on 15th January 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Lawrence House 25/01/06

Lawrence House 11/11/05

Lawrence House 17/12/04

Lawrence House 23/09/04

Lawrence House 10/03/04

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 Lawrence House Lawrence House Landkey Road Barnstaple Devon EX32 9BX Lead Inspector Susan Taylor Key Unannounced Inspection 15th January 2007 10:00 Lawrence House DS0000043932.V328633.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 Lawrence House DS0000043932.V328633.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. Lawrence House DS0000043932.V328633.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lawrence House Address Lawrence House Landkey Road Barnstaple Devon EX32 9BX 01271 377189 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) Linda Harvey Linda Harvey Care Home 12 Category(ies) of Learning disability (12) registration, with number of places Lawrence House DS0000043932.V328633.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. To provide personal care to twelve (12) service users between the age of 25 and 65 years with learning disabilities (LD) 25th January 2006 Date of last inspection Brief Description of the Service: Lawrence House provides 24-hour residential care for 10 people who have learning disabilities. At night-time there are two staff sleeping in. Lawrence House is a large detached Victorian house standing in its own grounds and is a short walk away from the centre of Newport. There is a ramp leading up into the rear entrance of the Home. Wheelchair users cannot easily be accommodated. Service users’ rooms are on the ground and first floors. All vary in size and have an outlook over the garden. The current fees range from £310 - £450 per week and are dependent upon individual assessed needs. Additional charges are made for hairdressing (ranges from £3.50 - £6.00 dependent upon individual requirements), chiropody (£11 per session), toiletries and newspapers (dependent upon individual requirements) and transport £60 per month. Lawrence House DS0000043932.V328633.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key inspection of Lawrence House under the ‘Inspecting for better lives’ arrangements. The inspector was at the home with people for 8½ hours. The purpose for the inspection was to follow up a requirement made at the last inspection about recruitment practices and look at key standards covering: choice of home; individual needs and choices; lifestyle; personal and healthcare support; concerns, complaints and protection; environment; staffing and conduct and management of the home. The inspector looked at records, policies and procedures at the office. A tour of the home took place. Surveys were sent to all ten people that live at Lawrence House, staff and four health and social care professionals: 90 of the people living at the home; 75 of staff and 50 health and social care professionals responded to the survey. The comments of the people who responded are included within the report. As at January 2007, the fees ranged between £310 and £450 per week for personal care. People funded through the Local Authority have a financial assessment carried out in accordance with Fair Access to Care Services procedures. Local Authority or Primary Care Trust charges are determined by individual need and circumstances. General information about fees and fair terms of contracts can be accessed from the Office of Fair Trading web site at www.oft.gov.uk What the service does well: People that live at Lawrence House say that it is a well run home. Other people such as professionals that support people who live there also hold this view. There is an inclusive atmosphere, in which people are encouraged to live their lives to the full. Also people say that they make decisions about what they want to do day to day and are helped to plan for the future. There is a good choice of appetising and well-balanced meals at Lawrence House. People say that they are listened to and their suggestions were reflected in changes to the menu for example. The activities, events and work that people do are tailored to their likes and dislikes. People said, “I like going to skittles” and “I like to help a lot, I do a bit of dusting and make sandwiches on Thursdays” and “I really like doing the washing up, we take it in turns to do it”. Family and friends are made welcome. Recent parties held over the Christmas period were said to be “hectic time” but “great fun”. Lawrence House DS0000043932.V328633.R01.S.doc Version 5.2 Page 6 There are policies and procedures that protect vulnerable people, including dealing with complaints. People know how to make complaints and say that they can voice their concerns and feel that staff listens to them. Appropriate checks are done before staff are allowed to work with the people that live at the home. All of the staff are said to be kind, caring and respectful to people. The manager encourages staff to do training so that they all keep up to date and understand how to care for people that live at the home. In terms of health and safety, people say that they feel safe at Lawrence House because “we do regular fire drills”. The home is clean, comfortable and well maintained. What has improved since the last inspection? 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. The summary of this inspection report can be made available in other formats on request. Lawrence House DS0000043932.V328633.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 Lawrence House DS0000043932.V328633.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): 1,2,3 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. Information given to prospective residents is pitched at the right level and helps them to make an informed decision about whether Lawrence House is the right home for them. People living at the home are supported and encouraged to be fully involved in the assessment process. EVIDENCE: 88 of people responding in a survey verified that they received enough information about the home before they moved in. At the home, people had a guide about the home that was in ‘total communication’ format. At the same time, people spoke about how they had been consulted at a meeting about a prospective resident. They showed the inspector minutes of the meeting and said that they had invited the person for tea and an overnight stay before they moved into the home. Three care files demonstrated that comprehensive assessment information had been obtained. Assessments had been regularly reviewed with the individual concerned. Excellent examples seen demonstrated how this had been done with people in documents entitled ‘My life my plan’ and ‘personal Lawrence House DS0000043932.V328633.R01.S.doc Version 5.2 Page 9 communication passport’, which contained information about what people wanted to achieve and what their social networks were. The home had obtained a copy of the care plan produced for care management purposes for people. In a survey, healthcare professionals that responded felt that Lawrence House meets the needs of people that live there and are satisfied with the care that they receive. Lawrence House DS0000043932.V328633.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7, 8 & 9 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. Care planning at Lawrence House is person centred. People living at the home have access to this information because the home has taken account of their diverse needs by using total communication formats. Financial systems protect the interests of people who need help to manage their money. The home manages to balance risks to promote the safety of people; whilst at the same time encourages people to be as independent as possible. EVIDENCE: Care plans were well maintained and in a ‘total communication format’. People said that their key workers spoke to them regularly about what their goals were. People showed the inspector documents such as documents entitled ‘My life my plan’ and ‘personal communication passport’, which contained information about what people wanted to achieve and what their social Lawrence House DS0000043932.V328633.R01.S.doc Version 5.2 Page 11 networks were. An advocate verified that they were always consulted about any important issues about a person that they support who lives at the home. The inspector read minutes of meetings, which demonstrated that a discussion had taken place about a prospective resident. Similarly, in a survey 100 of people verified that they make their own decisions about what they do during the day, during the evenings and at weekends. Three out of ten people felt that they did this with support from staff. One person wrote ‘sometimes I let my bedroom get a bit messy, but that’s my personal choice’. Additionally, staff responding in a survey wrote comments like ‘We try to give the service users choice and care for them as individuals’ and people are ‘supported to be as independent as possible so as to realise their full potential’. In a survey staff were positive about the ‘pleasant’ and ‘homely atmosphere’ that has been created for the people living there. At the same time, people are said to be treated with ‘dignity and respect all the time’ and have as ‘much choice as they can’. Three people’s financial records were examined. The individual’s concerned told the inspector that they were satisfied with the way their money is handled in the home. One person said, “we all have our own accounts” and statements were seen which verified this. Balances were audited and found to be in order. Two signatures were seen on balance sheets denoting withdrawals. The home had policies or procedures about risk assessment and management. In practice comprehensive risk assessments had been completed and were seen in three files that were examined in detail. Each one clearly laid down ways to minimise identified risks and hazards, whilst at the same time encouraged people to be as independent as possible. For example, one person worked in a local supermarket one day per week. Lawrence House DS0000043932.V328633.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 & 17 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. People that live at Lawrence House lead ordinary and meaningful lives in ways that enable them to maintain family and personal relationships. There are few restrictions at Lawrence House. Meals are well balanced, varied and take account of individual preferences and choices. EVIDENCE: Lawrence House DS0000043932.V328633.R01.S.doc Version 5.2 Page 13 Nine people were at home during the inspection and time was spent with each person. People felt that they lead very full lives living at Lawrence House. People made comments such as “I like going to skittles” and “I like to help a lot, I do a bit of dusting and make sandwiches on Thursdays” and “I really like doing the washing up, we take it in turns to do it”. One person was seen emptying the dishwasher and preparing the lunch with the manager. Every person had an activity program that was in ‘Total Communication’ format. A wide range of local resources was used and people verified that these reflected their individual interest such as swimming, tap dancing or clubs. People were coming and going from the home all day having been to work, college, or other activities in the community. The closure of local day services was said to have been an upsetting period for people, but in collaboration with another home imaginative and varied opportunities had been arranged that encouraged people to develop new skills. For example, a community tutor regularly visited people to teach them IT skills. Planned events and outings that had taken place over the Christmas period were documented in the minutes of meetings. People said that it had been a “hectic time” but “great fun”. Similarly, relatives responding in a survey that the home had carried out praised and thanked the team for the support they gave people in inviting them to parties over the Christmas period. In a survey an advocate verified that they were made welcome to visit their client at any time and could do so in private. People invited the inspector to have lunch with them, which was a lively event. With support from the manager, one person made a choice of sandwiches, yoghurt and fruit made according to the individual preferences of people. The record of meals provided demonstrated that menus were varied and that alternatives had been available to residents. Lawrence House DS0000043932.V328633.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 & 20 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. People are treated with dignity and respect. The home works in partnership with other professionals to meet the healthcare needs of the people that live there. Lawrence House has excellent systems for capturing medical information, which means that healthcare is individualised and takes account of people’s needs. EVIDENCE: In a survey 100 of people felt that staff listened and responded to their needs. All of the people that were at home. From information gathered in the pre-inspection questionnaire, the gender balance of people living at the home is relatively well matched to that in the staff team. In a survey of professionals, 100 of respondents felt that the home always followed their advice and managed the healthcare needs of people well. Lawrence House DS0000043932.V328633.R01.S.doc Version 5.2 Page 15 Two residents who had healthcare needs gave their views about how these were met. One person told the inspector “I have regular checks at the doctor’s and the staff keep a close eye on me”. Medication Administration Record charts are in use and no gaps in the records were seen. Whilst tracking the needs for one person, the inspector observed that medicines had been administered as prescribed. At the same time, the team had developed a ‘personal medication profile’ for the individual. This had been completed when the person moved into the home and had comprehensive medical and allergy information for staff to refer to. All medicines were seen to be stored in a new locked cupboard, which was securely affixed to the wall. Training records demonstrated that key staff involved in administering medication had received appropriate training. Additionally, the manager said that all new staff were supervised and their competency assessed before being able to administer medication on their own. Staff also verified this. Lawrence House DS0000043932.V328633.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. 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. People living at Lawrence House are protected and able to voice their concerns, if they have any, safe in the knowledge that these will be dealt with in an appropriate manner. EVIDENCE: 88 of people responding in a survey verified that they knew how to complain and who to speak to if they were unhappy. One person wrote that they had been ‘informed by support workers and management on the procedure to follow, where complaints forms are kept and how to fill them in’. The procedure was displayed on the wall next to the kitchen and was presented in ‘total communication’ format. No complaints had been received since the last inspection. 100 of people responding in a survey felt that the staff always treated them well and listened to them. The home had a written policy and procedure for dealing with suspected allegations of abuse. The inspector spent sometime observing interactions between staff and people living there. Staff engaged with people continuously at the right speed and demonstrated genuine warmth and attention, which people appeared to respond to and enjoy. Training records demonstrated that all of the staff had attended a course covering the protection of vulnerable adults. Two staff that the inspector spoke to Lawrence House DS0000043932.V328633.R01.S.doc Version 5.2 Page 17 individually during the inspection also verified this. In the pre-inspection questionnaire, the manager had written that ‘protection of vulnerable adults’ training had been booked for September 2007. Staff spoken to had a clear understanding of the concepts of whistle blowing and adult protection issues. The care records for one person demonstrated that a behaviour plan had been agreed between the home in collaboration with healthcare professionals and the individual themselves. Positive reinforcement was being used, and the individual said that the staff encouraged them to talk about their feelings rather than allowing themselves to become angry and frustrated. Lawrence House DS0000043932.V328633.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People live in a comfortable, well-maintained home that is clean. EVIDENCE: People showed the inspector their bedrooms, which reflected their individual tastes. One person said that they liked ‘sci-fi’ programmes and their room was full of memorabilia reflecting this interest. People made other comments in a survey, which demonstrated that people living at the home have a high level of independence, such as ‘sometimes I let my bedroom get a bit messy, but that’s my personal choice’. Similarly, the home was well maintained and one person’s comments demonstrated their level of involvement in choosing new furniture for their room in that they liked their ‘new bed’. Touring the premises the inspector saw that the home was clean and very well maintained. Lawrence House DS0000043932.V328633.R01.S.doc Version 5.2 Page 19 100 of people responding in a survey verified that their home was kept clean and fresh. Infection control measures such as hand washing had been discussed with people and staff. Notices in total communication format in prominent areas prompt people to follow good hand washing techniques. Safe systems were observed being followed with regard to separation of bed linen and clothing to maintain good infection control, whilst at the same time did not detract from some people being supported to participate in the process. Lawrence House DS0000043932.V328633.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34 & 35 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. A team of highly skilled and experienced staff cares for people living at Lawrence House. Recruitment procedures are followed and ensure that staff that have been properly vetted cares for people living at the home. Additionally, there is a training and development culture at the home that is constantly being reviewed and ensures that people are cared for by staff with the right knowledge and expertise. As such, staff might benefit from further training about dementia, which would also ensure that people with dementia receive good quality care. EVIDENCE: In a survey an advocate verified that there were always sufficient numbers of staff on duty. Staff in surveys wrote comments like ‘Lawrence House is a pleasant place to work and the very low staff turnover highlights this.’ The duty roster for the week of the inspection was examined and accurately recorded the names of staff, and duties that had been worked. The inspector observed that staff were attentive and supported people in an unhurried way. Lawrence House DS0000043932.V328633.R01.S.doc Version 5.2 Page 21 Three personnel records were examined. The home had obtained satisfactory references including CRB and POVA pre-employment checks. All of the staff that the inspector met verified that they had an individual portfolio and that their training needs are discussed through the supervision process. Individual training records provided evidence that training is ongoing and linked to the specific needs of people living in the home. For example, forthcoming training had been booked to provide staff with ‘signing’ skills so that they might be able to communicate more effectively with a person that was new to the home. All of the staff responding in a survey indicated that the home provides funding and time for them to receive training. Most recent training that staff had undertaken included fire awareness, safe handling of medicines and diabetes awareness. In discussion with staff and the manager, one of the people living at the home was showing signs of early stages of dementia. The manager recognized that sufficient training had not been done on dementia. The inspector recommended that all of the staff undertake a ‘positive dementia’ course to improve awareness and care of the individual concerned. Lawrence House DS0000043932.V328633.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. 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 this service. The registered manager is experienced and qualified to run the home and does so effectively for the people who live there. Quality assurance systems are evident and ensure that people’s views are respected in this home. It is important for the home to have a development and quality plan leading on from this. Similarly, people’s interests are safeguarded and efficiently managed. Health and safety is paramount and is effectively managed, which ensures that the people living there are protected. EVIDENCE: The registered manager’s portfolio verified that she has attained the Lawrence House DS0000043932.V328633.R01.S.doc Version 5.2 Page 23 Registered Manager’s Award and NVQ level 4 in Care and Management. All of the staff, relatives and healthcare professionals and people that live at Lawrence House feels that the home is well run. The atmosphere in the home is inclusive. Minutes of meetings held with people that live demonstrated that they are consulted about all aspects of their life there and that their views are listened to. 100 of people responding in a survey verified that the staff listened to them. Other communication systems were in place, which included regular staff handovers and regular staff meetings; minutes of these were seen and contained positive reassuring messages for the staff team. Two health and social care professionals responding in a survey indicated that the home communicates clearly and works in partnership with them. Since the last inspection, the manager said that she had worked on three areas that needed improvement, namely quality assurance, reviewed policies and procedures and implementation of person centred care. An annual development plan had yet to be written that makes links to people’s needs in the home and meeting the national minimum standards and regulatory requirements. The manager told the inspector that two internal audits had been carried out in 2006, and there were plans to send a satisfaction survey to everyone that had involvement with the home. In a survey staff were positive about the ‘pleasant’ and ‘homely atmosphere’ that has been created for the people living there. At the same time, people are said to be treated with ‘dignity and respect all the time’ and have as ‘much choice as they can’. Similarly, professionals responding in a survey were satisfied with the overall care of people living in the home. The pre-inspection questionnaire completed by the manager verified that contractors had carried out maintenance to hoists, electrical, gas, fire and water systems during the last 12 months. Comprehensive Health & Safety policies and procedures were seen, including a poster displayed stated who was responsible for implementing and reviewing these. Certificates seen on files examined verified that staff had attended infection control and manual handling training in the past 12 months. The fire log was examined and demonstrated that fire drills, had taken place regularly. Similarly, the fire alarm had also been regularly checked. People living at the home told the inspector that the alarm was regularly checked and “we do regular fire drills”. Certificated evidence verified that the assisted bath had been regularly maintained. First aid equipment was clearly labelled. Some of the staff on duty verified that they held a current first aid qualification having completed the National Vocational Qualification in Care. People said “the staff have done first aid training so we go to them if we have an accident and a report is filled out”. Electrical appliance checks and risk assessments had been reviewed in the last twelve months. Data sheets were in place and staff spoken to understood the risks and how to minimise these in respect of chemicals used in the building mainly for cleaning and infection control purposes. The home has Lawrence House DS0000043932.V328633.R01.S.doc Version 5.2 Page 24 an accident procedure that had been followed. Entries tracked by the inspector established that appropriate action had been taken following reported accidents. The manager told the inspector that she regularly audited accidents and incidents occurring in the home to ensure that these were kept to a minimum. Lawrence House DS0000043932.V328633.R01.S.doc Version 5.2 Page 25 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 4 2 4 3 4 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 x 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 4 4 x LIFESTYLES Standard No Score 11 x 12 4 13 4 14 x 15 4 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 4 x 3 4 2 x x 3 x Lawrence House DS0000043932.V328633.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? No 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. 2. Refer to Standard YA35 YA39 Good Practice Recommendations All staff should attend a ‘positive dementia’ course to improve their awareness and ensure that appropriate care is given to people living in the home that have dementia. An annual quality and development plan should be written following on from the feedback that people living in the home and professionals and relatives have given. This will ensure that everyone is clear about what needs to be improved, and how and when it will be done. Lawrence House DS0000043932.V328633.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Devon Area Unit D1 Linhay Business Park Ashburton Devon TQ13 7UP 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 Lawrence House DS0000043932.V328633.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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