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Inspection on 09/08/05 for London Road Neurological and Specialist Care Unit

Also see our care home review for London Road Neurological and Specialist Care Unit for more information

This inspection was carried out on 9th August 2005.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

London Road Neurological & Specialist Unit provides a high standard of care for all of their clients, of all ages and needs. Staff are to be commended for their high degree of professionalism and for the high standard of care afforded to their clients. The home is well run by a knowledgeable and experienced Registered Manager. Staff are caring and supportive towards the clients and their relatives. It is well decorated and maintained and provides a safe and homely environment for the clients. Clients` care plans are detailed to ensure that each individual`s varying and specific needs are met and the specific needs of clients with brain injury are well managed. Staff are well trained and able to meet the clients` needs. The Registered Manager`s knowledge and enthusiasm, with the support of other healthcare professionals, ensures that the clients receive optimum care at all levels. Comments from visiting healthcare professionals, the clients and their relatives, during the inspection, were very positive and demonstrated that they were very satisfied with the standard of care provided. Relatives said that the care was `excellent` and staff `went that extra mile` to ensure that the clients and their relatives received the care and emotional support that they required. London Road Neurological & Specialist Unit C51 C01 S1915 London Road V233019 090805 Stage 4.doc Version 1.40 Page 6Two healthcare professional were equally complimentary of the dedication and care provided by the staff and were particularly complimentary about the style of management which ensured that clients receive a high standard of care.

What has improved since the last inspection?

This was the first time the Inspector had inspected London Road Neurological & Specialist Unit. The home was compliant in all the requirements and recommendations made by the previous Inspector.

What the care home could do better:

This was a satisfactory inspection and no requirements or recommendations were made.

CARE HOME MIXED CATEGORY MAJORITY ADULTS 18-65 London Road Neurological & Specialist Unit 362 London Road Leicester Leicestershire LE2 2PU Lead Inspector Mrs Carole Burgess Unannounced 9 August 2005 09:30 am th 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 Older People and 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. London Road Neurological & Specialist Unit C51 C01 S1915 London Road V233019 090805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service London Road Neurological & Specialist Unit Address 362 London Road Leicester LE2 2PU 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) 0116 2706991 0116 2707181 road.freeserve.co.uk. Cheer Health Limited Mrs Judith Tart Care Home (CRH) 33 Category(ies) of Old age, not falling within any other category registration, with number (OP) 33 both, Physical disability (PD) 33 both, of places Physical disability over 65 years of age (PD(E)) 33 both, Terminally ill (TI) 6 both, Terminally ill over 65 years of age (TI(E))6 both. London Road Neurological & Specialist Unit C51 C01 S1915 London Road V233019 090805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. No person to be admitted to the home in categories TI or TI(E) when 6 persons in total of these categories/combined categories are already accommodated in the home. Date of last inspection 2nd February 2005 Brief Description of the Service: London Road Neurological & Specialist Unit provides nursing care for up to thirty-three clients, 18 years and over with a physical disability, and has specialist facilities for clients with acquired brain injury and those people who require palliative and terminal care. The unit is housed in a large, well adapted Victorian House, which has been extensively developed and modernised by the present owners. There are mainly single rooms, with a small number of double rooms with sufficient, adapted bathing faclilities. There is a main lounge on the first floor, large conservatory and a mature garden. There are Registered Nurses on duty at all times supported by care and ancillary staff . The home has two treatment rooms and a separate physiotherapy room. They employ a part time physiotherapist, an on call General Practitioner, and a Consultant responsible for clients with neurological conditions undertakes regular in house visits . The home is situated on a main road on the outskirts of Leicester, with all the attendent facilities of a large city centre, and is within half a mile of the train station . It is on a public transport route and has ample visitor parking. London Road Neurological & Specialist Unit C51 C01 S1915 London Road V233019 090805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over one day. An opportunity was taken to look around the home, view records, policies and care plans and to talk to staff, clients, their relatives and visitors. The primary method of inspection used was ‘case tracking’ which involved selecting three clients and tracking the care they receive through a review of their records, discussion with clients (where possible), relatives, prospective clients, the nursing and care staff, visiting healthcare professionals and the observation of care practices. Most of the clients were seen during the inspection. Three of the clients (who were able), five relatives, a prospective client, Physiotherapist and Speech and Language therapist gave the Inspector their impressions of the home. NB. The term ‘younger’ adult refers to those clients who fall within the age range of 18 – 65 year. ‘Older persons’ refers to clients who are 65 years or older. What the service does well: London Road Neurological & Specialist Unit provides a high standard of care for all of their clients, of all ages and needs. Staff are to be commended for their high degree of professionalism and for the high standard of care afforded to their clients. The home is well run by a knowledgeable and experienced Registered Manager. Staff are caring and supportive towards the clients and their relatives. It is well decorated and maintained and provides a safe and homely environment for the clients. Clients’ care plans are detailed to ensure that each individual’s varying and specific needs are met and the specific needs of clients with brain injury are well managed. Staff are well trained and able to meet the clients’ needs. The Registered Manager’s knowledge and enthusiasm, with the support of other healthcare professionals, ensures that the clients receive optimum care at all levels. Comments from visiting healthcare professionals, the clients and their relatives, during the inspection, were very positive and demonstrated that they were very satisfied with the standard of care provided. Relatives said that the care was ‘excellent’ and staff ‘went that extra mile’ to ensure that the clients and their relatives received the care and emotional support that they required. London Road Neurological & Specialist Unit C51 C01 S1915 London Road V233019 090805 Stage 4.doc Version 1.40 Page 6 Two healthcare professional were equally complimentary of the dedication and care provided by the staff and were particularly complimentary about the style of management which ensured that clients receive a high standard of care. 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. London Road Neurological & Specialist Unit C51 C01 S1915 London Road V233019 090805 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Individual Needs and Choices Lifestyle Personal and Healthcare Support Concerns, Complaints and Protection Environment Staffing Conduct of Management of the Home Scoring of Standards Statutory Requirements Identified During the Inspection Adults 18 – 65 (Standards 1–5) (Standards 6-10) (Standards 11–17) (Standards 18-21) (Standards 22–23) (Standards 24–30) (Standards 31–36) (Standards 37-43) Older People (Standards 1–5) (Standards 7, 14, 33 & 37) (Standards 10, 12, 13 & 15) (Standards 8-11) (Standards 16-18 & 35) (Standards 19-26) (Standards 27-30 & 36) (Standards 31-34, 37 & 38) London Road Neurological & Specialist Unit C51 C01 S1915 London Road V233019 090805 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 (Adults 18 – 65) and Standards 1 – 5 (Older People) are: 1. 2. 3. Prospective service users have the information they need to make an informed choice about where to live. (OP NMS 1) Prospective users’ individual aspirations and needs are assessed. No service user moves into the home without having been assured that these will be met. (OP NMS 3) Prospective service users’ know that the home that they choose will meet their needs and aspirations. Service Users and their representatives know that the home they enter will meet their needs. (OP NMS 4) Prospective service users’ have an opportunity to visit and “test drive” the home. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitablity of the home. (OP NMS 5) Each service user has an individual written contract or statement of terms and conditions with the home. Each service user has a written contract/statement of terms and conditions with the home. (OP NMS 2) 4. 5. The Commission considers Standard 2 (Adults 18-65) and Standards 3 and 6 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, 3, 4 & 5. The admission process is well managed. Clients and their relatives/representatives are given clear and detailed information regarding the service; thereby ensuring that the clients’ health and welfare needs will be met. London Road Neurological & Specialist Unit C51 C01 S1915 London Road V233019 090805 Stage 4.doc Version 1.40 Page 9 EVIDENCE: There is a comprehensive, recently updated, Statement of Purpose & Service Users’ Guide. Clients and/or their relative or representatives receive a signed contract of residence and a separate copy is kept on file in the home. The pre-assessment process, completed by either the Registered Provider or Registered Manager, both of whom are experienced and well qualified nurses, is detailed and reflective of the health, welfare and social needs of their clients. A prospective client spent part of the day looking round the home and had lunch. He said he was very impressed with the staff, the food and the standard of accommodation and wished to make it his home in the near future when he would no longer be able to care for himself. London Road Neurological & Specialist Unit C51 C01 S1915 London Road V233019 090805 Stage 4.doc Version 1.40 Page 10 Individual Needs and Choices The intended outcomes for Standards 6-10 (Adults 18-65) and Standards 7, 14, 33 & 37 (Older People) are: 6. Service users know their assessed and changing needs and personal goals are reflected in their Individual Plan. The Service Users health, personal and social care needs are set out in an individual plan of care. (OP NMS 7) Service users make decisions about their lives with assistance as needed. Service Users are helped to exercise choice and control over their lives. (OP NMS 14) Service users are consulted on, and participate in, all aspects of life at the home. The home is run in the best interests of service users. (OP NMS 33) Service users are supported to take risks as part of an independent lifestyle. The service users health, personal and social care needs are set out in an individual plan of care. (OP NMS 7) Service users know that the information about them is handled appropriately and that their confidences are kept. Service Users rights and best interests are safeguarded by the home’s record keeping, policies and procedures. (OP NMS 37) 7. 8. 9. 10. The Commission considers Standards 6, 7 and 9 (Adults 18-65) and Standards 7, 14, and 33 (Older People) 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. Clients (where possible) and their relatives are well informed and supported about the clients assessed care needs and are encouraged to participate in the decision making process. London Road Neurological & Specialist Unit C51 C01 S1915 London Road V233019 090805 Stage 4.doc Version 1.40 Page 11 EVIDENCE: The home has comprehensive care plans, which are regularly evaluated and updated. Relatives confirmed that they had been included in the care planning process where the client was unable to make a meaningful contributuion. Relatives of the clients who are receiving care following a brain injury are consulted about care during the review meetings with staff and Brain Injury Team. Most of the client group at London Road are significantly physically incapacitated due to the progressive and sever nature of their illness. Clients, who are able, are encouraged to risk take, where this is appropriate. Following evaluation and risk assessments clients are enabled to develop some degree of independence, albeit in small ways, which can result in improvements in their quality of life. Nursing staff provide relatives with information, advice and support in this matter where appropriate. Two relatives said that there relative, who had been resident for a short time, and had previously been completely bedridden, and not speaking, had been bathed, dressed, sat out of bed and had asked for chocolate. They were very impressed and happy with the progress their relative had made in the few weeks she/he was resident at London Road. London Road Neurological & Specialist Unit C51 C01 S1915 London Road V233019 090805 Stage 4.doc Version 1.40 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 (Adults 18-65) and Standards 10, 12, 13 & 15 (Older People) are: 11. Service users have opportunities for personal development. Service Users find the lifestyle experiencd in the home matches their expectations and preferences and satisfies their social, cultural, religious and recreational interests and needs. (OP NMS 12) Service users are able to take part in age, peer and culturally appropriate activities. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. (OP NMS 12) Service users are part of the local community. Service users maintain contact with family/ friends/ representatives and the local community as they wish. (OP NMS 13) Service users engage in appropriate leisure activities. Service users find the lifestyle experienced in the home matches their expectations and preferences and satisfies their social, cultural, religious and recreational interests and needs. (OP NMS 12) Service users have appropriate personal, family and sexual relationships and maintain contact with family/friends/representatives and the local community as they wish. (OP NMS 13) Service users’ rights are respected and responsibilities recognised in their daily lives. Service users feel they are treated with respect and their right to privacy is upheld. (OP NMS 10) Service users are offered a (wholesome appealing balanced) healthy diet and enjoy their meals and mealtimes. Service users receive a wholesome appeaing balanced diet in pleasing surroundings at times convenient to them. (OP NMS 15) 12. 13. 14. 15. 16. 17. The Commission considers standards 12, 13, 15, 16 and 17 (Adults 1865) and Standards 10, 12, 13 and 15 (Older People) 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. Clients experience a supported life style matched to their very individual and specific personal and nursing needs. London Road Neurological & Specialist Unit C51 C01 S1915 London Road V233019 090805 Stage 4.doc Version 1.40 Page 13 EVIDENCE: Visitors came and went throughout the day and spoke to the Registered Manager and staff about their relatives and any concerns they had. Most of the clients are severely limited, due to their condition, in their ability to participate in the usual types of activities. However, ranges of appropriate and focused activities are provided i.e. television, radio, DVD’s, music, aromatherapy, visiting hairdresser, physiotherapy, PAT dogs and visitors from the church. In addition, clients can have a telephone and Sky TV in their rooms. The home provides qualified nursing and healthcare professional support services, which includes physiotherapy and speech and language therapy. The Brain Injury Team, in partnership with the multi-disciplinary team, the clients, where appropriate, and their relatives, develop programmes of care to enable clients with brain injury to fulfil their own personal potential. Specialist equipment is provided, which includes a physiotherapy room, and multisensory equipment. Cultural and religious needs are supported. Menus are balanced and are flexible enough to accommodate the individual preferences and healthcare needs of the clients, many of whom require soft, puréed or liquidised feeds, and assistance with feeding. They meals are freshly prepared on site and are of a good standard. The Speech and Language therapist provides support and advice to staff regarding clients with swallowing or feeding difficulties. Both she and the visiting physiotherapist were very complimentary about the standard of care provided I relation to the provision of appropriately prepared food and feeding techniques, which ensures that clients receive the required nutrition . London Road Neurological & Specialist Unit C51 C01 S1915 London Road V233019 090805 Stage 4.doc Version 1.40 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 – 21 (Adults 18-65) and Standards 8 – 11 (Older People) are: 18. 19. 20. Service users receive personal support in the way they prefer and require. Service users feel they are treated with respect and their right to privacy is upheld. (OP NMS 10) Service users’ physical and emotional health needs are met. Service users’ health care needs are fully met. (OP NMS 8) 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. Service users, where appropriate, are responsible for their own medication and are protected by the home’s policies and procedures for dealing with medicines. (OP NMS 9) The ageing, illness and death of a service user are handled with respect and as the individual would wish. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. (OP NMS 11) 21. The Commission considers Standards 18, 19 and 20 (Adults 18-65) and Standards 8, 9 and 10 (Older People) 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 & 21. Clients are looked after very well in respect of their health and personal care needs. London Road Neurological & Specialist Unit C51 C01 S1915 London Road V233019 090805 Stage 4.doc Version 1.40 Page 15 EVIDENCE: Care plans are detailed and reflect clients’ specific and individual needs. Contact with other healthcare professional is well documented. The quality of record keeping is reflective of the high standard of nursing care observed during the inspection and ensures that the needs of the clients are fully met. Medication administration is managed effectively within the home’s medication policy and procedural guidelines to ensure the safe and timely delivery of clients’ prescribed medicines. The disposal of medication is under review but medicines for disposal were appropriately and safely stored. Observation during the inspection showed that staff have a good awareness of how to protect clients privacy and dignity. They were seen to be kind and patient and treated the clients in a respectful, friendly and supportive way. A client and five relatives said that staff are always respectful and very caring. The physiotherapist observed that when staff were feeding clients who were unable to communicate they were gentle, patient and chatted to the clients, even though the clients were unable to respond, to ensure that meal times were as pleasant as possible. London Road Neurological & Specialist Unit C51 C01 S1915 London Road V233019 090805 Stage 4.doc Version 1.40 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22-23 (Adults 18-65) and Standards 16, 18 & 35 (Older People) are: 22. 23. Service users feel their views are listened to and acted on. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted on. (OP NMS 16) Service users’ are protected from abuse, neglect and self-harm. Service users legal rights are protected. (OP NMS 17) Also Service users are protected from abuse. (OP NMS 18) Also Service users financial interests are sageguarded. (OP NMS 35) The Commission considers Standards 22 and 23 (Adults 18-65) and Standards 16, 18 and 35 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 & 23. Arrangements for receiving and responding to complaints are sound, resulting in satisfactory protection of clients’ rights. EVIDENCE: The complaints file was examined. Two minor complaints, received since the last inspection, were dealt with according to company policy and in an appropriate manner. The CSCI has not received any complaints about the home since and the home’s complaints process reflects the government’s adult protection guidelines, set out in the ‘No Secrets’ publication. Staff are aware of their responsibilities and have received appropriate training. London Road Neurological & Specialist Unit C51 C01 S1915 London Road V233019 090805 Stage 4.doc Version 1.40 Page 17 Environment The intended outcomes for Standards 24 – 30 (Adults 18-65) and Standards 19-26 (Older People) are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users live in a safe, well-maintained environment (OP NMS 19) Also Service users live in safe, comfortable surroundings. (OP NMS 25) Service users’ bedrooms suit their needs and lifestyles. Service users own rooms suit their needs. (OP NMS 23) Service users’ bedrooms promote their independence. Service users live in safe, comfortable bedrooms with their own possessions around them. (OP NMS 24) Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Service users have sufficient and suitable lavatories and washing facilities. (OP NMS 21) Shared spaces complement and supplement service users’ individual rooms. Service users have access to safe and comfortable indoor and outdoor communal facilities. (OP NMS 20) Service users have the specialist equipment they require to maximise their independence. Service users have the specialist equipment they require to maximise their independence. (OP NMS 22) The home is clean and hygienic. The home is clean, pleasant and hygienic. (OP NMS 26) The Commission considers Standards 24 and 30 (Adults 18-65) and Standards 19 and 26 (Older People) 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. A comfortable, well-equipped, homely and safe standard of accommodation is provided for the clients. London Road Neurological & Specialist Unit C51 C01 S1915 London Road V233019 090805 Stage 4.doc Version 1.40 Page 18 EVIDENCE: The home is safe and well maintained with many adaptations to suit clients’ varying and specific and specialised needs. It is decorated and furnished to a good standard which creates a comfortable and homely environment. There is a satisfactory system of maintenance and refurbishment. Clients’ rooms were clean and well decorated. Clients are able to bring items of their own furniture and possessions with them to personalise their rooms. All rooms were personalised with photographs, posters, ornament and soft toys etc. Some rooms have a lavatory and hand basin and there are additional toilet, bathing and assisted bathing facilities. A bathroom and toilet on the first floor may be refurbished into a large shower room. A recently purchased specialised bathing chair enables staff to shower clients who would not normally be safe to have a shower. On the day of inspection all areas of the home were clean and maintained to a good standard. Hot water temperatures are checked to ensure they comply with Health & Safety legislation and were satisfactory when checked during the inspection. London Road Neurological & Specialist Unit C51 C01 S1915 London Road V233019 090805 Stage 4.doc Version 1.40 Page 19 Staffing The intended outcomes for Standards 31 – 36 (Adults 18-65) and Standards 27 – 30 & 36 (Older People) are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported and protected by the home’s recruitment policy and practices. (OP NMS 29) Service users are supported by competent and qualified staff. Service users are in safe hands at all times. (OP NMS 28) Service users are supported by an effective staff team. Service users needs are met by the numbers and skill mix of staff. (OP NMS 27) Service users are supported and protected by the home’s recruitment policy and practices. Service users are supported and protected by the home’s recruitment policy and practices. (OP NMS 29) Service users’ individual and joint needs are met by appropriately trained staff. Staff are trained and competent to do their jobs. (OP NMS 30) Service users benefit from well supported and supervised staff. Staff are appropriately supervised. (OP NMS 36) The Commission considers Standards 34 and 35 (Adults 18-65) and Standards 27,29 and 30 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33 & 36. Staff at the home are trained, supported, and employed in sufficient numbers to meet the residents needs. London Road Neurological & Specialist Unit C51 C01 S1915 London Road V233019 090805 Stage 4.doc Version 1.40 Page 20 EVIDENCE: The Registered Manager maintains day-to-day responsibility for the home and is supernumerary. Staffing levels, at the point of inspection were satisfactory and above that indicated by the Department of Health Residential Forum Guidelines, and were sufficient to meet the clients’ needs. The home employs a mixed staff group consisting of Registered Nurses and care staff, supported by domestic, catering and maintenance personnel. In addition, there is a contracted physiotherapist, and a speech and language therapist who visit the home. There are always qualified nurses on duty, day and night to ensure that the clients nursing needs are met. Relatives said that the staff were capable and caring, and both relatives and staff said that they felt that there are sufficient staff on duty to meet the needs of the clients. Training supports staff in providing for the varied needs of their clients. New staff are provided with a comprehensive induction package. The Registered Provider said that ten of the care staff hold National Vocational Qualification (NVQ) in Care. ‘In house’ training supports staff in meeting the clients’ health and welfare needs. NB. Standards 34 & 35 were discussed but will be inspected in detail during the next unannounced inspection. London Road Neurological & Specialist Unit C51 C01 S1915 London Road V233019 090805 Stage 4.doc Version 1.40 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 (Adults 18-65) and Standards 31-34, 37 & 38 (Older People) are: 37. Service users benefit from a well run home. Service users live in a home which is run and managed by a person who is fit to be in charge of good character and able to discharge his or her responsibilities fully. (OP NMS 31) Service users benefit from the ethos, leadership and management approach of the home. Service users benefit from the ethos, leadership and management approach of the home. (OP NMS 32) Service users are confident their views underpin all self-monitoring, review and development by the home. The home is run in the best interests of service users. (OP NMS 33) 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 homes record keeping, policies and procedures. (OP NMS 37) Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. Service users rights and best interests are safeguarded by the homes record keeping policies and procedures. (OP NMS 37) The health, safety and welfare of service users are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (OP NMS 38) Service users benefit from competent and accountable management of the service. Service users are safeguarded by the accounting and financial procedures of the home. (OP NMS 34) 38. 39. 40. 41. 42. 43. The Commission considers Standards 39 and 42 (Adults 18-65) and Standards 33,35 and 38 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 38, 39, 40, 41, 42 & 43. The Registered Provider and the Registered Manager, are trained nurses, are knowledgeable, experienced and professional, and effectively supervise staff and manages the home to protect the rights and needs of their clients. London Road Neurological & Specialist Unit C51 C01 S1915 London Road V233019 090805 Stage 4.doc Version 1.40 Page 22 EVIDENCE: The Registered Provider is in day-to-day contact with the home and is fully cognisant of all the clients and their individual requirements. The Registered Manager is a Registered Nurse and has many years of experience in care and is well supported by a professional senior care staff team. There is an ethos of openness in the home; staff are friendly, helpful and very caring towards the clients, their relatives and each other. Staff help and support the clients to make decisions in their everyday life and promote a degree of independence where this is possible. The home does not manage any personal finances on behalf of their clients. The Registered Manager undertakes regular staff appraisals and supervision (a regular review of staff performance and training needs) to ensure that staff maintain the standards of care expected in the home. Health & Safety Policy and Procedures, such as regular recorded fire drills and fire alarm tests are completed, to assure the health and safety of the clients and staff. London Road Neurological & Specialist Unit C51 C01 S1915 London Road V233019 090805 Stage 4.doc Version 1.40 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. Where there is no score against a standard it has not been looked at during this inspection. 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 4 3 3 4 3 Standard No 22 23 Score 3 3 Score ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 4 4 3 3 3 4 3 3 3 3 4 4 Standard No 24 25 26 27 28 29 30 STAFFING 4 4 3 3 3 4 4 Score 11 12 13 14 15 16 17 Standard No 31 32 33 34 35 36 3 3 3 x x 3 4 4 4 3 3 3 3 Version 1.40 Page 24 CONDUCT & MANAGEMENT PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 London Road Neurological & Specialist Unit Score 4 4 3 3 37 38 39 40 41 42 43 C51 C01 S1915 London Road V233019 090805 Stage 4.doc 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 Regulation NONE Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard NONE Good Practice Recommendations London Road Neurological & Specialist Unit C51 C01 S1915 London Road V233019 090805 Stage 4.doc Version 1.40 Page 25 Commission for Social Care Inspection The Pavilions 5 Smith Way, Grove Park Enderby, Leicestershire LE19 1SX National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI. London Road Neurological & Specialist Unit C51 C01 S1915 London Road V233019 090805 Stage 4.doc Version 1.40 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!