Inspection on 03/08/05 for Lilliputs Farmhouse

This inspection was carried out on 3rd August 2005.

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 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Lilliputs Farmhouse 09/01/07

Lilliputs Farmhouse 05/12/05

Lilliputs Farmhouse 28/02/05

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

CARE HOME ADULTS 18-65 Lilliputs Farmhouse Wyngletye Lane Hornchurch Essex RM11 3BL Lead Inspector Edi OFarrell Unannounced Inspection 3 August 2005 11:10 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 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 Stationary 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. Lilliputs Farmhouse G55 S0000056267 Lilliputs Farmhouse V241961 030805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Lilliputs Farmhouse Address Wyngletye Lane, Hornchurch, Essex, RM11 3BL Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01708 620325 Care Management Group Limited Carol Ann Morrell CRH Care Home 6 Category(ies) of LD Learning Disability - 6 registration, with number of places Lilliputs Farmhouse G55 S0000056267 Lilliputs Farmhouse V241961 030805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: To include one named person under 18 years of age for a maximum period of four months up to 10/10/04 (pending the 18th birthday of the person) Date of last inspection 28 February 2005 Brief Description of the Service: Lilliputs Farmhouse is a six place care home for adults with severe learning disabilties, situated in a semi-rural part of Hornchurch. It opened in June 2004, and is on the same site as three other houses that form Liliputs, a care home for children with severe learning disabilties. Both homes are operated by Care Management Group, a large private company that provides similar adult services in other areas. The Farmhouse is a 16th Century listed building, and many of the original features, such as low doorways, have been retained. The house is decorated and furnished to a high standard, with all equipment, fixtures and fittings being domestic in nature. All six bedrooms are single, and well above minimum standard size. Five have an ensuite toilet and shower, with the sixth having a bath/shower room nearby. Two of the bedrooms are on the ground floor, and four on the upper floor; which is accessed by stairs; there is no lift. There is a large conservatory on the ground floor, with french windows that lead onto a patio and garden, with outdoor seating. A lounge, quiet room, kitchen, dining room, laundry and small office are also on the ground floor. The service users have free access to a large activity centre on the site, which has a swimming pool, soft play area, light and dark rooms, as well as well equipped teaching rooms for such things as art, cookery, and music. They also have access to the two horses that are kept on site, and the house car, and larger vehicles belonging to the childrens home. The site is on a bus route to Hornchurch and Romford. Lilliputs Farmhouse G55 S0000056267 Lilliputs Farmhouse V241961 030805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This, unannounced, inspection took place on a weekday from late morning to mid afternoon. It was timed for during the summer holidays, as some of the service users attend colleges during term time. This was the second inspection since the home was registered and, as at the first, the findings are very positive. The building was toured, staff and service users were spoken to, and records were checked. The grounds and activity centre were toured in March 2005 as part of an inspection of the other home on the site. The service users have a range of severe learning disabilities, which include limited verbal communication. Observation, examination of records, and discussions with staff were therefore used to form some of the judgements on the capacity of the home to meet service users’ needs. Staff and service users are thanked for their hospitality and input to the inspection. What the service does well: Lilliputs Farmhouse provides an extremely pleasant, comfortable, and safe home for the people who live there. They all have large, well-furnished, single bedrooms with their own shower and toilet. They are encouraged to have their own possessions in their rooms, and all take advantage of this. The communal space is a large and a small lounge, dining room, and large conservatory, and this means that service users can spend time with each other or alone. This is important for service users who find spending time with others to be difficult at times. Service users also use the large, and well-equipped, activity centre, which is on the same site. This has a swimming pool, soft play area, relaxation and stimulation rooms, as well as art, cookery, and music rooms. Each service user has an individual programme of educational, social and leisure activities, which include going to local collages, involvement in the running of the home, skills training, such as cookery, swimming and horse riding. They also have individual care plans, covering all their health and personal care needs, which are very person-centred. Service users are encouraged to choose their meals, and if necessary staff cook different things for them at meal times. Some nights there are takeaways, and there are also meals out at local restaurants. The staff enjoy working at the home, and have a warm and respectful relationship with the service users. The home is well managed and a lot of effort has gone into building a strong staff team since the home opened in 2004. The Commission uses a scoring system of 1 to 4 when inspecting homes against the National Minimum standards, with 4 being the highest. This is Lilliputs Farmhouse G55 S0000056267 Lilliputs Farmhouse V241961 030805 Stage 4.doc Version 1.40 Page 6 used to commend services for achieving above these standards. This home has been awarded seven scores of 4 at this inspection in recognition of the commitment to providing a high quality, and individualised, service. Management, staff, and service users, have all contributed to this, and are to be congratulated. 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. Lilliputs Farmhouse G55 S0000056267 Lilliputs Farmhouse V241961 030805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Lilliputs Farmhouse G55 S0000056267 Lilliputs Farmhouse V241961 030805 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, 3, 4 & 5 Service users, and their relatives, made informed choices about moving into the home, based on comprehensive assessment of need and full information about the proposed service. Service users have individual contracts. EVIDENCE: Five of the six care files were examined, along with the Statement of Purpose, and the Service User Guide. The Farmhouse was opened to meet the needs of some of the older children living at Lilliputs, so they already knew the site. There was evidence that care had been taken to introduce them to their new home by frequent visits in the transitional period. Where one service user had come from a home in Brighton visits had been arranged for both them and the staff of their, then, home. Their, and their relatives’ views, were sought throughout this introductory period. The placing authorities carried out comprehensive assessments, and this information has been used by the home to develop individual care plans. Each service user has a contract signed by the unit or registered manager, and the service user, where possible. Lilliputs Farmhouse G55 S0000056267 Lilliputs Farmhouse V241961 030805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7, 8, 9 & 10 Service users’ needs and aspirations are reflected in their individual plans, and staff support them to make decisions about their lives. They participate, as far as possible, in the life of the home, and are supported to take risks. Information on service users is handled appropriately. EVIDENCE: Five care plans were examined and compared with the service being provided. Staff were observed interacting with service users, and some elements of care were discussed with management. The service users are all young adults (aged 19 & 20) who have previously lived in residential homes for children. The risk assessments and care plans clearly recognise that they are young adults, who need to develop social and daily living skills within a safe environment. They also take account of the range and severity of learning and physical disability, and challenging behaviour that the service users have. Whilst verbal communication is limited, the service users have other means of communicating their wishes and views, such as use of picture cards, Makaton, and their behaviour. These are all well recorded in the care plans and daily records, and staff were observed to work in a very person-centred way with each individual. The care plan system Lilliputs Farmhouse G55 S0000056267 Lilliputs Farmhouse V241961 030805 Stage 4.doc Version 1.40 Page 10 identifies all personal care needs, and how these are to be met. Social needs, including sexuality and spiritual needs, are also identified. Health needs, some of which are quite complex, are also well documented with plenty of evidence that they are being met. Annual reviews, with the placing authorities have just started, with one having been held the day previous to the inspection. The service user and their relatives, whose views were all very positive, attended this meeting. It is obvious that management and staff have put a lot of hard work into this aspect of care and a score of 4, commendable, has been given in recognition of this. A score of 4 has also been given in recognition of the efforts that staff have put into including the service users in the life of the home. All six service users, no matter what level and complexity of disability, are included in household tasks, such as setting and clearing the table, shopping trips, and cleaning. They are consulted on in-house activities, and trips into the community. The care plans included full information as to how each service user can indicate their choices. Information on service users is locked in a filing cabinet and only shared on a need to know basis. Lilliputs Farmhouse G55 S0000056267 Lilliputs Farmhouse V241961 030805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11, 12, 13, 14, 15, 16 & 17. The service users lead very active and varied lives, which encourage personal development and learning. Their rights are respected, and they are encouraged and supported to take responsibility for their actions. Contact with families, friends, and access to the community are given a high priority. Service users are offered, and encouraged to take, a healthy diet. EVIDENCE: Five care plans were examined and activities were discussed with staff. Each of the six service users has a very varied activity programme, with four going to local colleges two to three times a week. A fifth person has just left school and has visited two day centres, with a view to starting to attend one after the summer holidays. Staff have attempted to find a college or day placement for the sixth service user, but this has proved impossible, due to behaviour problems. This service user’s activity programme utilised the facilities of the activity centre, and the local community. The activity centre, which is on site, has a range of facilities, such as a swimming pool, soft play area, light and sound stimulation, and relaxation rooms. It also has well equipped art and Lilliputs Farmhouse G55 S0000056267 Lilliputs Farmhouse V241961 030805 Stage 4.doc Version 1.40 Page 12 craft rooms, and domestic science kitchen. All these facilities are well used by the service users, three of whom were across there during the morning of the inspection. Staff keep a record of all activities. Service users’ preferences for social activities were reflected in their bedrooms, by equipment, such as CD player and TVs, and posters. One service user enjoys playing his electronic keyboard and demonstrated considerable skill in this activity during the visit. Some of the service users enjoy horse riding, which is encouraged as the homes have two horses, and there is a riding stable next door. Where service users have an allergy or fear of animals this is documented. Service users are encouraged to learn new daily living and social skills, such as making drinks, and snacks, and are also included on all food shopping trips. Five service users are due to go on holiday to Butlins in September, whilst the sixth has recently been to the Philippines, his parent’s homeland, for a month, with his parents and a member of staff. Each of the care plans clearly states the preferred contact by families, and this ranges from visits home on a weekly basis, and which relatives wish to retain contact, and which do not. Attendance at places of worship are included in care plans and facilitated by staff. The menu is set weekly, with each service user deciding what they want. The night staff, using photos of different types of food, facilitate this. These were examined, and they cover the whole range of meals that the home provides. Staff have started adding to the basic pictures by taking photos of other foods. The menu for the current week was seen, as were the records of all food taken that are kept in the care plans. One member of staff reported that most of the service users would have burgers and chips every night, but that staff try to steer them towards a balanced diet. Other favourite meals are spaghetti bolognaise, takeaways, and sausages and mash. There was a plentiful supply of fresh fruit and vegetables in the kitchen, and all opened jars or packages were date labelled. Fridge and freezer temperature are recorded on a daily basis and these were examined. A score of 4 has been given to this Standard as there was a lot of evidence that staff work hard to assist service users to made individual choices in relation to meals. This can sometimes mean that several separate meals have to be cooked, but wherever possible these are all cooked from fresh ingredient, rather than using convenience food. Lilliputs Farmhouse G55 S0000056267 Lilliputs Farmhouse V241961 030805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19 & 20 Service users receive personal support in the way they prefer and their physical and emotional health needs are met. Due to the level of disability service users are unable to control their own medication, so staff always administer it. There are policies and procedures in place to ensure that this is done safely. Some changes are needed to practice to improve the level of safety. EVIDENCE: Medication Administration (MAR) charts were examined, the medication trolley and other storage areas were examined, and some aspects were discussed by phone with one of the Commission’s specialist pharmacist inspectors. The findings were discussed with a staff member, the unit manager and the registered manager. Some points, such as liquid medication bottles, and the trolley, being very sticky, were rectified during the inspection, so no Requirement has been set, but this will be checked at the next inspection. The member of staff was advised that staff giving out liquid medication should wipe bottles afterwards, as labels can easily become obscured. Wherever possible medication is supplied in blister packs, and where there was a tablet remaining from a previous week the MAR chart had been correctly filled in to explain why. One prescription checked was for a weekly dose and this was in a separate container. According to the MAR chart nine tablets had been given, and there Lilliputs Farmhouse G55 S0000056267 Lilliputs Farmhouse V241961 030805 Stage 4.doc Version 1.40 Page 14 was one remaining in the container. The stock section of the MAR chart was not filled in, but it was possible to check the amount of tablets received as the home keeps a separate book for this. This showed that eight tablets had been received on the last prescription, so some tablet must have been brought forward. The staff member was able to provide a full explanation for this anomaly but a full audit would only be possible by going back through previous MAR charts and the medication received records. The stock section of the MAR chart must be filled in to show the total amount of tablets and liquid at the start of each MAR chart period. In addition staff are not signing and dating the prescriptions that they hand write on the charts. This is Requirement 1. The Commission accept that the home had in previous months complied with both elements of this Requirement, but the practice must be consistent. Lilliputs Farmhouse G55 S0000056267 Lilliputs Farmhouse V241961 030805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 & 23 Staff take great care to understand how service users express their views, and respond appropriately. Some additional training in adult protection needs to be arranged, so that all staff understand how to protect service users from potential abuse. This training needs to identify the differences between child protection and adult protection. EVIDENCE: The complaint procedure is available in both written English and symbols, and both versions include details of who to contact at the Commission. The symbol depicting the Commission is a stick person with a clipboard. There have been no complaints since the home opened, but the Commission is satisfied from discussions during the inspection that should there be any they would be dealt with promptly. Despite limited verbal communication the service users are well able to make their views known by their behaviour. The records demonstrated that staff take careful note of behaviour, and what it might mean, and make changes to routines in response where they can do. Examples are changes to activities, choice of day centres, and organising separate activities where service users are known to ‘wind each other up’. A number of staff working at this home transferred across from the children’s home, and are therefore very well versed in child protection. Some staff have also attended an adult protection course. This needs to be built on so that all staff have a comprehensive knowledge of adult protection, including the key differences between the systems, policies, procedures, and principles, of child and adult protection. The service users are very vulnerable young adults, and the home has a philosophy of maximising independence, therefore they are a Lilliputs Farmhouse G55 S0000056267 Lilliputs Farmhouse V241961 030805 Stage 4.doc Version 1.40 Page 16 very high-risk group that require maximum protection. In addition this is a mixed gender home, with service users who have identified inappropriate behaviour, which they do not recognise as being sexual, which puts them at greater risk. Staff therefore need to be very knowledgeable in this area of care. This is Requirement 2. Discussion was held with the Registered Manager about appropriate resources for both the staff and the service users, and the Commission will provide contact details as a follow up to this inspection. Lilliputs Farmhouse G55 S0000056267 Lilliputs Farmhouse V241961 030805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 25, 26, 27, 28, 29 & 30 Service users live in an extremely homely, comfortable, and safe environment. Their bedrooms suit their needs and promote independence. The shared space, including the use of the activities centre and outdoor space, complements and supplements their individual rooms. The home is clean and hygienic and any specialist equipment that is needed to maximise independence is provided. EVIDENCE: The home was toured, including all bedrooms. The grounds and activity centre were toured as part of the March 2005 inspection of other home on the site. Service users were observed moving around the home, and one service user demonstrated how he uses his bedroom to pursue his interest in music. The home was opened in June 2004. It is a 16th Century, listed building, which retains many of the original features, such as low doorways. The house was previously privately owned and on moving the family left much of the furniture and fittings. This results in a very homely environment for service users to live, and staff to work, in. All bedrooms are above minimum standards in size, with five having ensuite toilets and showers and the sixth having a bathroom Lilliputs Farmhouse G55 S0000056267 Lilliputs Farmhouse V241961 030805 Stage 4.doc Version 1.40 Page 18 and toilet close by. The home was very clean and tidy yet had a lived in feel, and service users obviously felt comfortable in moving about the home. One service user declined to show her room, but agreed to it being inspected, as did others. Four of the environmental Standards have been scored at 4, commendable, as this home offers a high quality environment, which must contribute to the quality of service users’ lives. The facilities provided in the activity centre far surpass those available in many day centres for adults with learning disabilities. These are well used by the service users who live in this home. Lilliputs Farmhouse G55 S0000056267 Lilliputs Farmhouse V241961 030805 Stage 4.doc Version 1.40 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, & 35. Service users benefit from a competent and committed staff team, who obviously enjoy working at the home, and strive hard to meet the needs of service users. The staff team is efficient and effective at identifying and meeting needs. EVIDENCE: Staff were observed interacting with service users, and carrying out their duties. Care and training records were examined, as well as the staff rota. There is a warm relationship between staff and service users, and staff had a demonstrable knowledge of the needs of each service user, and how these should be met. Considerable effort has gone into training the staff who moved across with the service users, and into team building. As recommended at the previous inspection Makaton training has been held. Please also refer to previous sections of this report, which comments on how staff comprehensively meet the needs of service users. Lilliputs Farmhouse G55 S0000056267 Lilliputs Farmhouse V241961 030805 Stage 4.doc Version 1.40 Page 20 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 38, 40 & 41 The home is run in the best interest of the service users; it is well managed, with a good quality of leadership. The home’s record keeping, and policies and procedures safeguard service users’ rights and best interests. A quality assurance system needs to be put in place, which includes seeking the views of service users and their representatives. EVIDENCE: Records were checked, staff and service users were asked for their views, and also observed, and the findings were discussed with management. All the evidence from previous sections of this report points to a well managed home, where the needs of the service users come first. The current Registered Manager also manages the children’s home, and the company have decided to appoint a separate manager for the farmhouse. The Lilliputs Farmhouse G55 S0000056267 Lilliputs Farmhouse V241961 030805 Stage 4.doc Version 1.40 Page 21 interviews for this new post took place on the morning of the inspection. The person appointed will be applying to the Commission for registration. All policies and procedures are in place, so that staff are clear how to carry out all parts of their jobs. A manager external to the home visits monthly, and produces a report, which uses a comprehensive checklist based on the NMS. Copies of these reports are sent to the Commission, who use them as part of monitoring the service between visits. A service user survey was carried out last year, but no report has been produced. The home has now been open for over a year, so a quality assurance system needs to be in place. This needs to include seeking the views of service users, their relatives, and other people who visit the home, such as social workers, nurses, and GPs. The information gained must then be used to produce an annual development plan for the home. This helps in the home continuing to offer the best possible service. This is Requirement 3. Lilliputs Farmhouse G55 S0000056267 Lilliputs Farmhouse V241961 030805 Stage 4.doc Version 1.40 Page 22 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 4 3 4 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 4 4 4 4 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 4 Standard No 31 32 33 34 35 36 Score 3 3 3 x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Lilliputs Farmhouse Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score 3 3 2 3 3 3 3 G55 S0000056267 Lilliputs Farmhouse V241961 030805 Stage 4.doc Version 1.40 Page 23 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 YA20 Regulation 13 (2) Requirement The total stock of tablet and liquid medication held at the start of use of each MAR chart must be recorded on the chart. All prescriptions hand written by staff onto the MAR charts must have a signature and a date. All staff must have training in the protection of vulnerable adults. This must include clarity as to each staff members responsibilty to report any potential abuse, and the differences between child and adult protection policies and procedures. A Quality Assurance system must be in place. This system must include seeking the views of service users and their representatives, about the service. A copy of the report must be forwarded to the Commission, and be made available to service users, and their representatives. Timescale for action 31/08/05 2. YA23 13 (6) 31/12/05 3. YA39 24 31/12/05 Lilliputs Farmhouse G55 S0000056267 Lilliputs Farmhouse V241961 030805 Stage 4.doc Version 1.40 Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations Lilliputs Farmhouse G55 S0000056267 Lilliputs Farmhouse V241961 030805 Stage 4.doc Version 1.40 Page 25 Commission for Social Care Inspection Ferguson House 113 Cranbrook Road Ilford IG1 4PU National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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