Inspection on 29/04/05 for Lynton Terrace, 1-3

This inspection was carried out on 29th April 2005.

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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Lynton Terrace, 1-3 09/05/07

Lynton Terrace, 1-3 04/12/06

Lynton Terrace, 1-3 23/05/06

Lynton Terrace, 1-3 13/10/05

Lynton Terrace, 1-3 20/09/04

Lynton Terrace, 1-3 01/06/04

Lynton Terrace, 1-3 23/06/03

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

CARE HOME ADULTS 18-65 1-3 Lynton Terrace Lynton Road Acton London W3 9DU Lead Inspector Jane Collisson Unannounced 29 April 2005 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. 1-3 Lynton Terrace Version 1.10 Page 3 SERVICE INFORMATION Name of service 1-3 Lynton Terrace Address Lynton Road, Acton, London W3 9DU 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) 0208 992 3343 0208 992 1154 Hestia Housing & Support Care Home 10 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (10) of places 1-3 Lynton Terrace Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 20/9/04 Brief Description of the Service: 1/3 Lynton Terrace is a detached property, situated in a residential area of Acton and close to Acton Main Line Station and bus routes. Acton Town Centre is within a mile and there are local shops nearby. The home is a mental health facility for ten service users, providing medium to long-term accommodation. Hestia Housing and Support own and manage the home. The communal rooms consist of two lounges, a dining room, kitchen, and games room on the ground floor, and a small kitchenette on the first floor. There are ten single bedrooms, four of which are on the ground floor. There are a total of three bathrooms for ten service users, one of which has a separate shower. All of the bathrooms have toilets and there is one separate toilet. The sleeping-in room, which has its own bathing facilities, is on the first floor. There is a small garden to the rear, with a separate building which houses the laundry room. The staff team consists of a Project Manager, two Deputy Managers, and a team of five Project Workers who support service users with personal care, practical tasks and leisure activities. At the time of this inspection, there was a Manager Designate who commenced work in October 2004 and there were no staff vacancies. The domestic work is contracted to an agency. 1-3 Lynton Terrace Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out on the 29th April 2005, between 11.35am to 5.55pm, for a total of 6 hours. The Manager Designate, who commenced work in the home in October 2004, was present together with three members of staff. The Manager Designate has applied to be registered with the Commission for Social Care Inspection. There has been no Registered Manager in post for more than three years due to several changes of management staff. A number of changes to the staff team have also taken place. Six of the ten service users were met during this inspection. One service user was on holiday with his family and the remaining three service users were out of the home. Since the last inspection in September 2004, one service user has died and a new service user has been admitted. At the last inspection, twelve requirements were made and four were found to have been fully met. Eight have been repeated and eight further requirements have been made. Several of these are in respect of promoting the opportunities for the service users to participate more in the running of the home and enjoy additional activities. The service currently has a full staff team, with two members of staff on each shift between 9am and 9.30pm. One staff member sleeps in at night and there are no waking night staff. The Manager Designate confirmed that these staffing arrangements were currently meeting the service users’ needs. However, one service user was being provided with additional staffing by the purchasing authority, for a limited period. The majority of the service users are able to go out unaccompanied and pursue their own interests. Whilst it is demonstrated that the home enables the service users to make choices about their lifestyle, which they confirmed, there is a lack of emphasis on supporting the service users to maintain and develop their daily living skills and extend their educational and leisure pursuits. This has been of concern at previous inspections and does not appear to have been progressed. A more positive approach in supporting the service users to widen their interests is required. The staff team does not reflect the gender mix of the service user group as there is currently only one female member of staff and four female service users. The Manager Designate said that he will be addressing this by employing a female staff member on a short-term contract. A longer term solution should be considered by actively employing female staff should staff vacancies occur. 1-3 Lynton Terrace Version 1.10 Page 6 The areas of the home seen on this inspection were found to be maintained in a reasonable condition although the smoking areas are in need of redecoration. The garden is small but poorly maintained. This could be greatly improved as an area for the service users to enjoy, with the addition of comfortable furniture for relaxation and plants. The staff training programme, which was the subject of a requirement at the previous inspection, is still required to be improved as staff need to have access to a range of training to support people with mental health needs. In particular, the lack of motivation by the service users, which was observed on this inspection, needs to be addressed. What the service does well: 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 full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. 1-3 Lynton Terrace Version 1.10 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 1-3 Lynton Terrace Version 1.10 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, 5 It needs to be shown that the needs and aspirations of the service users are more clearly in evidence and linked to the home’s stated aims and objectives. It is not demonstrated that service users are motivated to work towards these aspirations, particularly where they may wish to move to less supported living. EVIDENCE: At the last inspection, the Statement of Purpose was required to be revised to take into account staff changes, and to be submitted to the Commission for Social Care Inspection. This was carried out but, due to staff changes, this will be required to be revised again. It was also required that the aims and objectives of the home are kept under review to ensure that the needs of the service users can be meet by the current staffing levels and facilities. The Statement of Purpose states that the home provides “medium-long term high quality care and accommodation for people with enduring mental health needs, who are subject to the Care Programme Approach” and that it “maximises opportunities for residents to integrate into the local community, including move-on to less supported accommodation where appropriate”. The likelihood of the current service users being able to move to less supported living was discussed with the Manager Designate. It needs to be demonstrated, for the service users who may be able to achieve this, that sufficient opportunities are in place for them to work towards this objective. At present, there is a lack of evidence that this is actively pursued. Only one service user, for instance, is able to self-cater on 1-3 Lynton Terrace Version 1.10 Page 9 a regular basis. There is very limited input into encouraging service users to take a more active part in the running of the home. The newest service user had been issued with a licence agreement. Additional schedules have been added to inform the service users of the items which the home provides, such as furniture, and the costs for which they are responsible. 1-3 Lynton Terrace Version 1.10 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 8, 9 Although the service users are able to make their decisions about their lifestyles but it has not been shown that they are encouraged to development and expand their interests. This is an area which the management team must address. EVIDENCE: The service users have care plans which are generally amended when Care Programme Approach meetings take place. They were seen to have signed these. However, for the most recently admitted service user, no care plan or risk assessments had been prepared, other than those carried out by professionals before admission. In order to assist the service users to be supported fully, care plans need to be drawn up to demonstrate that the home is able to meet and support their assessed needs. Risk assessments are essential to show that the home has considered all of the areas where there may be concerns or possible hazards. All this needs to be carried out with the involvement of the service user, and their support networks, to show that the home is suitable for them. Any restrictions that may be placed upon them must be detailed. 1-3 Lynton Terrace Version 1.10 Page 11 Each service user has a key worker in the staff team, who arranges a monthly meeting, which is recorded. Service users may choose not to participate, in which case this is also recorded. It has been of concern at previous inspections that service users have not been seen to be offered opportunities to participate in the day-to-day running of the home and to maintain and develop social and independent living skills. Little progress appears to have been made. Motivating and encouraging the service users to improve these skills would be beneficial for those who may wish to move on to more independent living and would provide occupation and interest for those who may not be able to do so. Although small financial rewards are given to service users to assist with tasks, it was discussed with the Manager Designate that there may be additional ways in which service users could be motivated. Staff would benefit from specialist training to develop the skills to encourage and motivate service users with mental health needs. Hestia continues to have a Tenant Participation Officer who holds meetings with the service users on a regular basis. Risk assessments were in place for the majority of the activities undertaken by the service users, with the exception of those for the newest service user. There are procedures in place for when service users are missing, including photographs. 1-3 Lynton Terrace Version 1.10 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16, 17 11, 12, 14, 15, Service users are seen to be able to choose how to spend their time and to pursue some community and leisure interests. However, the opportunities offered to extend their personal development are not in evidence. A more positive approach is required by the staff to motivate and support the service users in their daily lives. EVIDENCE: At previous inspections, the absence of a permanent staff team had appeared to be a factor in the lack of continuity in the support for the service users. In particular, the giving of monetary incentives to the service users was not linked to a programme to maintain and develop their skills. This remains the same. In order to support the service users, staff need to demonstrate that every effort is made to assist the service users to fulfil their potential and this is not in evidence. Service users have regular access to key workers, or other member of the staff team, with whom they can discuss any concerns or problems they may have. 1-3 Lynton Terrace Version 1.10 Page 13 None of the current service users are involved in paid work and none attend college courses. One service user attends a work rehabilitation programme, which includes gardening and cookery and indicated that this is an experience he enjoys. The other service users seen did not express any wish to participate in educational or day activities, but may need support to be motivated to do so and the staff team need to demonstrate that opportunities are offered. One service user was on holiday with his family at the time of the inspection, but no holidays are offered as part of the home’s services. Some service users have indicated that they would like to have a holiday and this is an area which should be considered as part of their individual programmes. Day outings are planned for this year and the service users who attend said that they find these enjoyable. Those service users who wish to attend access a mental health drop-in facility. Links with families are maintained wherever possible and one service user has a family member who visits the home on a regular basis. Service users are able to spend the time with their families if they wish to do so and can maintain contact by telephone. Although there are complaints and concerns made by service users about each other, there are also friendships within the home which appear to be beneficial to the service users involved. The routines in the home are generally those which are chosen by the service users but are also planned around the medication regimes required. The service users seen during this inspection were watching television or spending times in their bedrooms. The restrictions placed on one service user are documented. The menu is produced, with some involvement by the service users, and offers a main meal, a vegetarian alternative and a diabetic alternative. Service users said that they could have an alternative if they preferred to do so. On the day of the inspection staff prepared a meal of lasagne, meat or vegetarian, with salad and chips. Tinned peaches and cream were served as the dessert. Staff said that not all of the service users have good appetites. Meals which are actually taken by the service users are not recorded and it is required under Regulation 17 (2), Schedule 4 (13) of the Care Homes Regulations 2001 that this should be done to ensure that service users are seen to be offered a nutritious, wholesome and varied diet. Although service users are listed on the menu to assist with the cooking, staff said that this did not usually happen. The service users in the home at the time of the inspection indicated that they did not wish to be involved. However, this is an area where motivation to be involved in the catering could be beneficial to some of the service users and needs to be encouraged. 1-3 Lynton Terrace Version 1.10 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19, 20 The support required to support the service users with their personal care, health needs and medication is in place. EVIDENCE: Staff said that there are no service users requiring full assistance with their personal care but some require prompting. There are three bathrooms for the ten service users and each bedroom has a washbasin. The health needs of the service users are detailed in their care plans. Service users are supported by Community Psychiatric Nurses with their injections either in the home or at the clinic. One service user was due to attend the clinic on the day of the inspection but, although encouraged by staff to do so, had chosen not to go. Staff said that they would see that the service user attended at the next opportunity. One service user has insulin-dependent diabetes and staff support is given to help the service user monitor blood sugar levels. Guidelines were not in place for the epilepsy regime for one service user and this must be recorded as part of the care plan. The home uses a Monitored Dosage System for dispensing medication. One service user is supported to partly self-medicate and signs for his own medication. 1-3 Lynton Terrace Version 1.10 Page 15 The home was previously required to monitor the controlled drug register to ensure that staff sign the register appropriately. This was seen to have been done at this inspection. 1-3 Lynton Terrace Version 1.10 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22, 23 The service users are able to express their concerns and complaints and the records showed that these are recorded and discussed as appropriate. A possible adult protection issue has been ongoing for some time and it was not demonstrated that sufficient action was being taken to minimise the risk to the service user. EVIDENCE: The service users have taken the opportunity to use the complaints procedures and nine complaints were seen to be recorded since the last inspection in September 2004. These were in relation to concerns about the behaviour of other service users. A schedule of complaints had previously been kept in the home and it is recommended that this is reinstated. An analysis of the complaints could be useful to support the service users to improve their relationships with the service users with whom they have regular difficulties. The Manager Designate said that complaints are a standing item on staff meeting agendas. In order to ensure the protection of service users, it was previously required that staff must be aware of the adult protection procedures in relation to the Protection of Vulnerable Adults legislation. The Manager Designate said that all staff, except for the two newest, have attended training. A short training session had also taken place at a staff meeting. There have been a number of concerns with regard to the possible financial abuse of one service user. A meeting was due to be held on the day of the inspection with the service user’s social worker but this was postponed. There had been no Care Programme Approach meeting following the most recent incident as the Community Psychiatric Nurse was on holiday. The service user has been reluctant to have outside involvement but it was discussed with the Manager Designate that 1-3 Lynton Terrace Version 1.10 Page 17 appropriate action must be taken to protect the service user from losing money and this needs to be demonstrated. 1-3 Lynton Terrace Version 1.10 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 25, 27, 29, 30 The home has not progressed with the provision of additional furniture and fittings for the service users’ bedrooms. Areas of the home require redecoration and refurbishment. There is scope for improving the facilities available in the home for leisure, including the garden. EVIDENCE: There are three communal areas that can be used by the service users, in addition to the dining room. The smaller lounge is designated as the nonsmoking room and now has a computer which is intended for the use of the service users. The Manager Designate said that it is hoped that it will have internet access. A strong extractor fan is used in the larger lounge, as it is in continuous use by service users who smoke, and it is in need of redecoration. There is a games rooms located in the garage which has had limited use. In order to make the most of the facilities available, the use of this room should be discussed with the service users, to see if better use could be made of the area. The garden is small, but has not been well maintained. There is scope to make this a more pleasant area for the service users to enjoy, particularly in the summer. Maintaining the garden could also be used as a source of recreation 1-3 Lynton Terrace Version 1.10 Page 19 for some of the service users. The provision of comfortable garden furniture may encourage service users to enjoy the fresh air and provide an outdoor eating area. The service users’ bedrooms were not seen on this inspection as the previous requirements, made at two inspections, to ensure that service users have adequate and suitable furniture and fittings provided in their bedrooms, had not been carried out. This requirement was made as it was seen that some service users had insufficient storage for their belongings, which did not support them to keep their rooms in a reasonable order. The Manager Designate said that an audit was being taken of the rooms but this was not complete and he said that the provision of the furniture and fittings would be addressed within the new budget. Service users should be offered the choice of the items detailed in the National Minimum Standard 24 and supported to maximise the space in their rooms, in accordance with their preferences. The radiators in all bedrooms, except the one which is an awkward shape, are reported to be covered. This is required to be carried out. The home has three bathrooms for the use of ten service users. It has been planned to refurbish the ground floor bathroom, which contains a separate shower and a bath but this work has not yet been agreed. The condition of the surface of the bath is poor, making it difficult to clean satisfactorily. Although there is domestic support for the communal areas, the tidiness and cleanliness of the bathroom required attention. The staff need to support the service users to maintain a good standard and a pleasant environment for all those who use the facilities. An Action Plan is required to show when the bathroom will be refurbished. At the inspection in September 2004, the provision of equipment to suit the needs of the service users with hearing impairments was required to be kept under review and risk assessments carried out. The Registered Manager stated that this has been done and service users have visited the relevant professionals, although do not always choose to use the equipment provided. An agency is engaged to provide a part-time cleaner for the communal areas of the home. These were reasonably clean but, with ten service users in the home, attention needs to be paid by the staff to support the service users to maintain a pleasant environment for all. 1-3 Lynton Terrace Version 1.10 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 33, 34, 35, 36 The lack of a permanent manager and staff team has not aided the home to provide a good level of consistency to the service users. The recruitment of a full staff team should improve this situation and allow for the staff training and development required to benefit the service users by providing greater motivation and attention to the service users’ needs. EVIDENCE: The many changes to the management and staff team have not benefited the staff in post to develop their roles and responsibilities. Now that there is a more stable staff team, work needs to be carried out with them to develop their roles to better support the service users. It has been required at previous inspections that the staffing levels are kept under review to ensure that the needs of the service users are being met. There is single staff cover before 9am and after 9.30pm, with one member of staff sleeping in. Additional hours have been put in place on a temporarily basis for one of the service users. The Manager Designate said that the hours currently in place are sufficient to meet the needs of the service users. Following the last inspection, the information required under Schedule 4 (6) of the Care Homes Regulations 2001 was required to be available for all staff working in the home. Two of the staff records examined on this inspection did 1-3 Lynton Terrace Version 1.10 Page 21 not have all of the information required, including full employment histories. The dates of employment were not included in the references obtained, which does not allow for verification of the information on the application form. All of the information for agency staff has not been obtained. The Manager Designate needs to ensure that, for the protection of service users, all recruitment and employment information needs to be obtained and be available for inspection. A requirement for staff to have the training appropriate to the duties they have to perform, including specialist mental health training, was made at the last inspection. The basic and ongoing training to support people with mental health needs is essential in a mental health facility. No further mental health training has been undertaken and this is an area of development which must be addressed. Staff have generally only undertaken a one-day course and specialist training is required to support service users who have complex needs. Two new staff were due to undertake their induction training in May 2005. The company has a commitment to NVQ training and four of the staff are undertaking NVQ Level 4 in care. The Manager Designate has submitted his Registered Managers Award and was awaiting the result. He is also studying for a Masters Course in Disabilities Management. One of the Deputy Managers was also undertaking the Registered Managers Award. A Project Worker is taking NVQ Level 3 and another is to reregister, following a long period of absence from the home. TOPSS training is being undertaken by two staff, leading to NVQ Level 3. Evidence was seen of staff supervision sessions having taken place. Regular staff meetings take place. 1-3 Lynton Terrace Version 1.10 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 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) 38, 42, 43 Systems are in place for the efficient management of the home but these need to be monitored by senior staff, on a regular basis, to ensure that they are maintained. Now that a permanent staff team is in place, staff roles and responsibilities need to be developed for the benefit of the service users and the smooth running of the home. EVIDENCE: The home has been without a Registered Manager for more than three years. There have also been changes to the management team and support staff. This has not assisted the home to fully develop its support for the service users. The current Manager Designate is applying for registration with the Commission for Social Care Inspection and there are now two Deputy Managers and a permanent team of support workers, which should aid this process. The home’s policies and procedures were not examined on this inspection. 1-3 Lynton Terrace Version 1.10 Page 23 It has been a requirement at two inspections that the staff must all participate in regular fire drills. The Registered Manager said that this had not been fulfilled. It must be ensured that, for the safety of service users and staff, all staff participate in the drills and the records are able to demonstrate that this has been done. The Manager Designate said that following a recommendation at the last inspection a new logging system had been introduced to improve the monitoring of maintenance and repairs. A previous requirement to have the remaining radiators in the home covered or regulated to ensure safety for the service users who are at risk has now been met with the exception of one radiator. This work needs to be completed for the safety of the service user. Servicing for the fire extinguishers, fire alarms and emergency lighting have been carried out in 2005. An informal visit was made by the London Fire and Emergency Planning Authority in April 2004 found the fire precautions satisfactory. Copies of the current budget were not available in the home for inspection and it is required that these, and the previous accounts, are made available for inspection. The Manager Designate said that he is in the process of putting together a business plan. 1-3 Lynton Terrace Version 1.10 Page 24 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 3 2 x x 3 Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 x 2 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 2 x 2 x 3 3 Standard No 11 12 13 14 15 16 17 2 2 x 3 3 3 2 Standard No 31 32 33 34 35 36 Score 3 x 3 1 2 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 3 x Standard No 37 38 39 40 41 42 43 Score x 3 x x x 2 2 1-3 Lynton Terrace Version 1.10 Page 25 YES 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 2&8 Regulation 12 (1) (b) 16 (2) (m) & (n) Requirement The service users must be offered further opportunities to participate in the day-to-day running of the home and to maintain and to develop social and independent living skills.(Previous timescale of 30/11/04 not met) Risk assessments must be completed for new service users for all areas of activity. Care plans must be completed for new service users in respect of the health and welfare and in consultation with them. Programmes to promote and maintain the welfare and wellbeing of the service users must be in evidence.(Previous timescale of 30/11/04 not met) It must be demonstrated that the opportunties for educational and day activities are actively offered and encouraged. A record of the meals taken by service users is required to be maintained to demonstrate that a wholesome, nutritious and varied diet is available. Guidelines for the action to be taken in relation to a service Version 1.10 Timescale for action 31/8/05 2. 3. 6 6 13 (4) (b) & (c) 15 (1) & (2) 12 (1) (a) 30/6/05 30/6/05 4. 11 31/7/05 5. 12 12 (1) (b) 30/6/05 6. 17 17 (2) Schedule 4 (13) 12 (1) 31/5/05 7. 19 15/6/05 1-3 Lynton Terrace Page 26 users epilepsy must be in place. 8. 23 13 (6) Action must be taken to protect service users from possible abuse situations and minimise the risks. The maintenance of the garden must be improved. Adequate and suitable furniture and fittings must be provided in bedrooms to meet the needs of the service users. (Previous timescale of 30/11/04 not met) An Action Plan is required for the refurbishment of the ground floor bathroom. The information required under Schedule 4 of the Care Homes Regulations 2001 must be available for all staff working in the home. (Previous timescale of 31/10/04 not met). Staff must have training appropriate to the duties they have to perform, including specialist mental health training. (The previous timescale of 30/11/04 not met). All staff must be involved in regular fire drills.(The previous timescale of 31/10/04 not met). The remaining radiator must be covered or regulated to ensure safety for the service users who are at risk. (The previous timescale of 30/11/04 not met). There must be available sufficiently detailed information for the home to demonstrate the financial viability for the purpose of carrying out the aims and objectives in the Statement of Purpose. (The previous timescale of 30/11/04 not met). 30/6/05 9. 10. 24 25 23 (2) (o) 16 (2) c 31/7/05 31/7/05 11. 12. 27 34 23 (2) (b) 19 Schedule 4 (6) 31/7/05 31/7/05 13. 35 18 (1) (c) (i) 31/7/05 14. 15. 42 42 23 (4) e 13 (4) (a) & (c) 30/6/05 31/7/05 16. 43 25 (1) 30/6/05 1-3 Lynton Terrace Version 1.10 Page 27 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 22 Good Practice Recommendations A schedule of complaints and concerns should be in place to enable those raised by service users on a regular basis to be addressed. 1-3 Lynton Terrace Version 1.10 Page 28 Commission for Social Care Inspection Ground Floor 58 Uxbridge Road Ealing London W5 2ST 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 1-3 Lynton Terrace Version 1.10 Page 29 - 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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