Inspection on 06/11/06 for Lynton

This inspection was carried out on 6th November 2006.

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

The inspector found no outstanding requirements from the previous inspection report, but made 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Lynton 30/09/09

Lynton 19/04/09

Lynton 22/04/08

Lynton 16/04/07

Lynton 03/11/05

Lynton 25/05/05

Lynton 20/09/04

Lynton 29/04/04

Lynton 22/07/03

Similar services:

Insight - Eastchurch

Southfields

Thorndene

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 Lynton London Road Ashington West Sussex RH20 3JS Lead Inspector Mrs M McCourt Unannounced Inspection 6th November 2006 08:30 Lynton DS0000014618.V320313.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 Lynton DS0000014618.V320313.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. Lynton DS0000014618.V320313.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lynton Address London Road Ashington West Sussex RH20 3JS 01903 893406 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) jallies@btinternet.com www.caremanagementgroup.com Care Management Group Limited Post Vacant Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Lynton DS0000014618.V320313.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Up to 3 male and / or female Service Users in the category learning disabliity may be admitted. Only persons between the ages of 18 - 65 years may be admitted / accomodated. 3rd November 2005 Date of last inspection Brief Description of the Service: Lynton is a care home that is registered to provide care for three adults with learning disabilities between the ages of 18-65. The Registered Provider is Care Management Group Ltd and the Registered Manager’s post is currently vacant. The current scale of monthly charges ranges from 1,080 to 1,532.08. This information was obtained from the most recent Statement of Purpose held by the Commission for Social Care Inspection. It does not state whether or not there are additional charges. Lynton is a detached property, with accommodation provided on two floors. In addition there is a pleasant garden area that can be easily accessed by the residents. The home is located in a residential area of Ashington, a small village approximately 20 minutes from both Worthing and Horsham town centres. There is a bus service from the village that connects with mainline trains. There are local shops and a pub in the village and residents can access nearby leisure facilities, colleges and work placements. The Service Users Guide and Statement of Purpose are currently at Head Office, waiting to be updated and returned to the home. Lynton DS0000014618.V320313.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A key unannounced inspection was undertaken by one Inspector on Monday 6th November and lasted a total of five hours. Pre-inspection planning took approximately two days. Preparation for the inspection included review of information, the request and examination of a Pre-Inspection Questionnaire, reading of various policies and procedures, including; admissions/referral procedures, staffing rotas, menus, complaints policy and any complaints received by the Commission for Social Care Inspection. A full tour of the building took place and included the observation of Health and Safety matters, hygiene issues, decorative order and a general overview of the atmosphere created within the home. One staff member and the home’s manager were spoken to at the time of inspection. The Inspector has also spoken with a representative from Worthing CTPLD regarding issues relating to the home. Case tracking was carried out by examination of relevant records and information held on the staff and residents. The Inspector also spoke with two of the Service Users accommodated at the home. Policies and procedures were examined during the site visit. What the service does well: Contracts between the home and Service Users are in place and have been signed by both parties. Those looked at gave Service Users a wide range of information and were considered a good example of an agreement. Service Users enjoy a variety of leisure activities, including; bowling, shopping, trips out and occasional visits to local town centres for meals and so on. One Service User spoken with showed the Inspector photographs from his recent holiday, and spoke about how he had enjoyed the experience. In addition, weekly timetables were on display for individuals and demonstrated that the home endeavours to provide Service Users with meaningful activities Service Users spoken with confirmed that staff do respect choice and dignity by knocking before entering rooms, choosing when to get up at weekends, when to eat and so on. Menus are decided at weekly residents meetings, and Service Users spoken with said they liked the meals cooked at the home. One Service User spoken Lynton DS0000014618.V320313.R01.S.doc Version 5.2 Page 6 with said that the food is very good and he sometimes helps staff to make the meals. Service Users live in a homely, comfortable environment with access to a range of communal areas. What has improved since the last inspection? What they could do better: The management of Lynton must be reviewed, and a Registered Manager recruited to the home as a priority. The home is actively recruiting to increase staffing levels. Currently there is high use of agency staff, which affects the quality of care offered to Service Users. Once in post, staff must be offered appropriate training and support in order to carry out their duties. The Inspector found that supervision is not offered regularly and there were no supervision contracts in place. In addition, none of the staff have obtained NVQ. Care plans are not being reviewed on a regular basis, and the Inspector noted that it is difficult to look through personal files as they are disorganised. A Service User who moved into the home recently, is still waiting to have a care needs review undertaken, and from this a support plan put into place. Records showed that there are numerous gaps in monitoring, sometimes days at a time. In addition the Community Team for People with Learning Disabilities has written to the home with concerns about missed appointments. Risk assessments and risk strategies are not being reviewed on a regular basis and the Inspector could not find evidence of review meetings taking place, although the manager said that they did. All risk management strategies need reviewing and updating. Medication administration and storage is in need of reviewing, details of which can be found in the main body of the report. The registered provider must ensure that appropriate steps are taken to remedy this situation and a requirement has been made in respect of this. Lynton DS0000014618.V320313.R01.S.doc Version 5.2 Page 7 The Commission for Social Care Inspection has received some complaints about the home and these must be investigated and addressed fully by the home. The home must also ensure that all complaints are recorded, regardless of how minor they are considered. 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. Lynton DS0000014618.V320313.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Lynton DS0000014618.V320313.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 and 5. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Prospective Service Users individual needs are assessed by the home prior to admission, although the home should ensure it can provide the appropriate level of care to support those needs. An up-to-date Statement of Purpose and Service Users Guide should be available for inspection and to Service Users and/or visitors at all times. EVIDENCE: The home is waiting for an updated version of their Statement of Purpose and Service Users Guide to be returned from Head Office. The old documents were available for inspection and the Service Users Guide is written in a suitable format for the client group, using makaton symbols and clear language. The Inspector examined two personal files to ensure the assessment process is carried out for Service Users admitted to the home. The home had carried out their own assessment on individuals, but for one Service User there was no evidence of an assessment by the placing authority. Lynton DS0000014618.V320313.R01.S.doc Version 5.2 Page 10 Service Users do have an agreement in place between them and the home. Those contracts looked at had been signed by the individual and a representative of the home. The contract covers health, psychology, communication, care needs, relationships, cultural needs and so on and was considered to be a comprehensive document. Lynton DS0000014618.V320313.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8 and 9. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home attempts to support Service Users to take risks as part of an independent lifestyle, but risk assessments and care plans must be reviewed regularly to ensure continuity of care. Service Users could benefit from the support of a local advocacy service. EVIDENCE: The Inspector sampled two personal files and of those, one file contained a Care Plan, known as Individual Support Requirements, although the second personal file did not. One Service User, admitted to the home in May this year is still waiting to have a care needs review undertaken, and from this a support plan put into place. The manager told the Inspector that this was due to the Service User being new to the service, and therefore the home is in the process of collating information about his care needs. The Inspector was of the opinion that a care plan should have been put into place following the Lynton DS0000014618.V320313.R01.S.doc Version 5.2 Page 12 home’s own assessment, which was carried out at the time of admission. The Service User concerned is under guardianship and is required to have fifteen minute observations. However, this is not sustainable. Records showed that there are numerous gaps in monitoring, sometimes days at a time. In addition the Community Team for People with Learning Disabilities has written to the home with concerns about missed appointments. Care plans are not being reviewed on a regular basis. The Inspector noted that it is difficult to look through personal files as they are disorganised. There are many documents; Individual Support Requirements, Guidelines, Action Plans, Review Sheets, Risk Assessments and so on which make it confusing to find the right information at the right time. Risk assessments seen for one Service User are due to be reviewed in November 2006, although several have no review date on. A monthly review sheet, which is a general overview of care, was seen for September 2006, but no others. Another file looked at showed that the monthly reviews had been carried out consistently between Jan 2005 and June 2006, but nothing since then. The Inspector could not find evidence of review meetings taking place, although the manager said that they did. All risk management strategies need reviewing and updating. Action plans are all dated June 2005 and have not been reviewed since March 2006, although were done regularly up until then. Guidelines for various activities are in place but also need reviewing. The Inspector spoke with one of the Service Users who has lived at Lynton for six months. He said that he goes out bowling to the cinema and has recently been on a five day holiday to Minehead in Devon. He showed the Inspector photographs from the holiday, which he said he enjoyed. Service Users meetings are held every week on a Thursday. The Inspector saw three sets of minutes from the last four months. Action points for requests made by Service Users would be beneficial so that issues can be tracked. The Inspector suggested that the Service Users run their own meetings as they are capable of doing so, and one Service User in particular showed a keen interest in undertaking the role of Chair. The home does not have details of local advocacy services, although one Service User in particular would benefit from their support. Lynton DS0000014618.V320313.R01.S.doc Version 5.2 Page 13 The home does have written procedures for unexplained absences and a missing persons procedure is in place. Lynton DS0000014618.V320313.R01.S.doc Version 5.2 Page 14 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): 11, 12, 13, 14, 15, 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service Users are able to take part in age, peer and culturally appropriate activities. Where Service Users’ rights are restricted, the home must provide clear evidence to explain why this is so. EVIDENCE: Weekly timetables were on display for individuals and demonstrated that the home endeavours to provide Service Users with meaningful activities. One Service User attends college four times each week, and subjects covered include IT, managing money, numeracy, farm/livestock and so on. On discussion with him he told the Inspector how he really enjoys gardening and would like to work towards working in a garden centre. Lynton DS0000014618.V320313.R01.S.doc Version 5.2 Page 15 Service Users enjoy a variety of leisure activities, including; bowling, shopping, trips out and occasional visits to local town centres for meals and so on. One Service User told the Inspector that he has friends, some from the home next door and some that he sees at college. The Inspector noted that visitors are not allowed into Service Users’ bedrooms, and there was no evidence of risk assessments to explain why this is so. Service Users do however hold keys to their own rooms. Service Users spoken with confirmed that staff do respect choice and dignity by knocking before entering rooms, choosing when to get up at weekends, when to eat and so on. Menus are decided at the weekly residents meetings, and Service Users spoken with said they liked the meals cooked at the home. One Service User spoken with said that the food is very good and he sometimes helps staff to make the meals. The team leader said that a record of meals eaten is kept in a log book. Lynton DS0000014618.V320313.R01.S.doc Version 5.2 Page 16 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Care planning must be carried out for all Service Users admitted to the home. Monitoring and reviewing of care needs must be carried out at regular intervals to ensure continuity of care. Medication is not being administered or stored in keeping with the Pharmaceutical Guidelines. EVIDENCE: Assessments carried out by the home were seen on personal files, however the Inspector was of the opinion that advice and support must be sought by professional health specialists as soon as a Service User moves into the home. As previously highlighted, not all reviews, risk assessments and care plans were up-to-date. Lynton DS0000014618.V320313.R01.S.doc Version 5.2 Page 17 The Inspector observed that Service Users can choose when to get up, and a discussion with one of the Service Users confirmed that this was true for him on non-college days. The Inspector examined the administration and storage of medicines. Medication is stored in a lockable, metal cabinet within the office. Some medicine is kept in blister packs, dispensed by Boots and some is held in boxes. There were large quantities of Lorazepam and Epilim being stored, for which there was no written stock control. The manager did therefore not know how many tablets there should have been. On looking at the blister packs the Inspector saw that two tablets should have been administered to a Service User that morning, but they were still in the pack. The tablets had been signed as given. The manager spoke on the telephone with the member of staff responsible for the administration that day, to try to clarify the situation. However, the staff member said that the tablets had definitely been given. The registered provider must ensure that appropriate steps are taken to remedy this situation and a requirement has been made in respect of this. Lynton DS0000014618.V320313.R01.S.doc Version 5.2 Page 18 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. All concerns, regardless of how minor, should be recorded in order to track outcomes. Although the home does provide appropriate training for staff, the lack of permanent staff could put Service Users at risk from abuse, neglect and selfharm, especially due to the complex needs of those living at the home. EVIDENCE: The Commission for Social Care Inspection has received several complaints via Ashington Parish Council, on behalf of neighbours, about the home. In addition the Worthing CTPLD have contacted the Inspector regarding concerns about the service. The Inspector asked to look at the complaints book. The home keeps two books; one for complaints by the neighbours and one for occurrences. There were two complaints logged in the neighbours book, however a complaint received by the Inspector and acknowledged by the home via a Regulation 37 incident was not recorded in it. Neither were complaints received by the Commission for Social Care Inspection regarding noise levels. Lynton DS0000014618.V320313.R01.S.doc Version 5.2 Page 19 A Service User spoken with said that although he had not seen a complaints procedure, he would speak to the manager if he had any concerns. Staff files looked at demonstrated that they are trained in Adult Protection procedures. The home does have a copy of the West Sussex County Council AP procedures available and kept in the office area. The Inspector asked a staff member about access to local advocacy services. There were no details available and little awareness. In the Inspector’s opinion one of the Service Users living at the home could benefit from support from an advocacy agency. Lynton DS0000014618.V320313.R01.S.doc Version 5.2 Page 20 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service Users live in a homely, comfortable and safe environment and the home is clean and hygienic. Maintenance issues should be resolved as soon as possible. EVIDENCE: The Inspector conducted a tour of the building. All three bedrooms looked at were found to be comfortable and personalised to suit individual taste, with one bedroom having access to en suite facilities. Currently two individual rooms were in the process of being redecorated. Service Users have access to a lounge, dining room, newly decorated kitchen and a small sized garden, accessible through the dining room, which was well maintained. Lynton DS0000014618.V320313.R01.S.doc Version 5.2 Page 21 The Inspector noted that the downstairs shower room & toilet could do with redecorating. The hot tap was not working and the team leader said that this was an on-going problem, and had been so for approximately eighteen months. The upstairs bathroom is also in need of redecoration. The team leader said that a complete new bathroom suite is due to be delivered next week. Service Users are able and only one needs support with personal care, therefore infection control practices are not of high priority. Lynton DS0000014618.V320313.R01.S.doc Version 5.2 Page 22 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 and 36. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home should endeavour to provide a full staff team in order to effectively support Service Users and their needs. Service Users would benefit from a well supported and supervised staff team. EVIDENCE: The staff team consists of two and a half permanent staff, and the home is actively recruiting to increase this level. The full compliment of staff should be five plus a part-time position. As a result there is high use of agency staff. On the morning of the inspection there should have been an agency worker on shift with the team leader, however the agency had not confirmed a name and so the team leader was working alone. Normally there would be two staff on duty am and pm with one sleep in person to cover nights. None of the staff have obtained NVQ. Lynton DS0000014618.V320313.R01.S.doc Version 5.2 Page 23 There are no staff meetings held, probably due to the staffing issues, although the manager said they would start soon, when more staff have been recruited. The Inspector examined recruitment documents and found them to contain the information required to protect Service Users from harm. Although the home does not have a training/development plan, there are individual training records for staff. The manager said that an assessment form is used to book staff’s training. A training programme offering various courses is sent to the home monthly. The manager then identifies training needs and puts forward names to attend. However, the Inspector was told that the courses get booked up very quickly and he struggles to get staff on relevant training. Supervision is not offered regularly and there were no supervision contracts in place. One member of staff who started working at the home approximately six weeks ago, still has not had any supervision sessions. The team leader has received only three supervision sessions in the last twelve months. Service Users spoken to said that the permanent staff are excellent, but that problems arise when agency staff are on shift, particularly if both shifts are covered using agency staff. Lynton DS0000014618.V320313.R01.S.doc Version 5.2 Page 24 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39 and 42. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home has been without a Registered Manager for some months now, and this has affected the outcome of some of the standards. Staff would benefit from regular mandatory training on all subjects as set out in the National Minimum Standards. Policies and procedures are in place and have been reviewed recently. Service Users would benefit from more regular in-house quality assurance monitoring. EVIDENCE: Lynton DS0000014618.V320313.R01.S.doc Version 5.2 Page 25 The acting manager, Mr Dan Dunman is also managing the establishment next door and this is having a knock-on affect to the smooth running of Lynton, because the manager’s time is largely spent at the other home. The Inspector was also concerned that the home is being run as an addition to the main one, as staff are sometimes used to work across the two homes. A Registered Manager must be recruited as a priority. The registered provider must ensure that appropriate steps are taken to remedy this situation and a requirement has been made in respect of this. Quality assurance is in the form of an annual questionnaire that is sent to residents, staff, visitors and interested parties to fill in and return to CMG’s head office where they are processed. Data is then recorded from these questionnaires and from the Residents’ Forum and disseminated back to the homes for implementation by the Home Manager. This year’s questionnaires were sent out in May. The manager said that every six months staff do a ‘Day in the Life of…’ exercise with individual Service Users, which he said was very useful in finding out about people and how they are. The Inspector suggested that the questionnaire be carried out more frequently. Policies and procedures were last reviewed in April 2006. Fire risk assessments need to be carried out for the Service User recently admitted. A fire file is in place, and contains policies and procedures. There is a contract between the home and D R Davis Ltd, who last visited in February 2006. Equipment checks were carried out in August of this year and fire drills were carried out in March, April, May and October this year, although the forms suggest that they are to be done monthly. Staff are given training in mandatory subjects, although records show that some are still to be attended, in particular, infection control and COSHH awareness. Lynton DS0000014618.V320313.R01.S.doc Version 5.2 Page 26 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 x 2 2 3 x 4 x 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 2 28 3 29 x 30 3 STAFFING Standard No Score 31 x 32 2 33 2 34 3 35 2 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 2 x LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 2 1 x 1 2 2 x x 2 x Lynton DS0000014618.V320313.R01.S.doc Version 5.2 Page 27 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 YA2 Regulation 14 (2) Requirement The registered person shall ensure that the assessment of the Service User’s needs is – (a) kept under review; and (b) revised at any time when it is necessary to do so having regard to any change of circumstances. Unless it is impracticable to carry out such consultation, the registered person shall, after consultation with the Service User, or a representative of his, prepare a written plan as to how the Service User’s needs in respect of his health and welfare are to be met. The registered person shall make suitable arrangements for the recording, handling, safekeeping and safe administration and disposal of medicines received into the care home. The registered provider shall appoint an individual to manage the care home where (a) there is no registered manager in respect of the care home. The registered person shall ensure that any complaint made under the complaints procedure is fully investigated. DS0000014618.V320313.R01.S.doc Timescale for action 31/12/06 2 YA6 15 (1) 31/12/06 3 YA20 13 (2) 31/12/06 4 YA37 8 (1) 31/01/07 5 YA22 22 (3) 31/12/06 Lynton Version 5.2 Page 28 6 YA36 18 (2) 7 YA33 18 (1) (a) The registered person shall ensure that persons working at the care home are appropriately supervised The registered person shall ensure that at all times suitably qualified, competent and experienced persons are working at the care home in such numbers as are appropriate for the health and welfare of service users 31/12/06 31/01/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard YA32 YA39 Good Practice Recommendations 32.6 – 50 of care staff (including agency staff) in the home achieve a care NVQ 2 by 2005. 39.6 – Feedback is actively sought from Service Users (with support from independent advocates as appropriate) about services provided through e.g. anonymous user satisfaction questionnaires and individual and group discussions, as well as evidence from records and life plans; and informs all planning and review. 42 – The Registered Manager ensures so far as is reasonably practicable the health, safety and welfare of Service Users and staff. (see section 42.2) 3 YA42 Lynton DS0000014618.V320313.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Lynton DS0000014618.V320313.R01.S.doc Version 5.2 Page 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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