Inspection on 19/06/07 for Maybury Court

This inspection was carried out on 19th June 2007.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Maybury Court 02/06/09

Maybury Court 28/02/06

Maybury Court 14/09/05

Maybury Court 12/10/04

Maybury Court 06/07/04

Maybury Court 19/02/04

Similar services:

Snydale Care Home

Abbey The

Larchfield Manor

Hawkhills

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE Maybury Court 802-808 Holderness Road Hull East Yorkshire HU9 3LP Lead Inspector Janet Lamb Unannounced Key Inspection 19th June 2007 09:30 X10015.doc Version 1.40 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 DS0000000862.V343697.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 Older People. 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. DS0000000862.V343697.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Maybury Court Address 802-808 Holderness Road Hull East Yorkshire HU9 3LP 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) 01482 704629 F/P 01482 704629 Mrs Diane Crowther Mrs Diane Crowther Care Home 28 Category(ies) of Dementia - over 65 years of age (28), Old age, registration, with number not falling within any other category (28) of places DS0000000862.V343697.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. To provide care for one named service user under the age of 65 years Date of last inspection 28th February 2006 Brief Description of the Service: Maybury Court is a building, which consists of two adjacent houses connected on the ground floor by a corridor. Maybury court is registered to provide care for up to 28 older people who may also suffer from dementia. The home is situated on a busy road on the outskirts of the City of Kingston upon Hull. Shops, health services, recreational facilities and public transport are all easily accessible. Within the home are one large and two smaller lounges and a dining room for communal use. Two staircases and a passenger lift allow access to the first floor. Outside the home is a patio, garden area and car park. The current fees for the home are £334.50 per week. DS0000000862.V343697.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Key Inspection of Maybury Court took place over a period of time and involved sending a request for information to the home in January 2007 concerning service users and their family members, as well as staff and details of the home’s policies, procedures and practices. The Commission received the requested information in early March 2007 and questionnaires were then issued to all service users and their relatives, their GP and any other health care professional with an interest in their care, to social service departments commissioning their care and to the staff working in the home. This information obtained from surveys and information already known from having had contact with the home over the last few months, was used to suggest what it must be like living there. A site visit was made to the home on 19 June 2007 to test these suggestions, and to interview service users, staff, visitors and the home manager. Some documents were viewed with permission from those people they concerned, and some records were also looked at. The communal areas of the home were viewed, along with two bedrooms on the ground floor. Four service users and three staff were interviewed and the provider/manager, and one relative were asked to provide information during the site visit and all of the information collected was checked against that already obtained through questionnaires and details known because of previous information gathering and contact with the home. What the service does well: The service carries out good assessments of service users’ needs before placements begin and these are written in a care plan, which details individuals’ differing needs because of race, religion, culture, disability, gender or sexuality etc. All service users feel their needs are well assessed and documented. It meets all assessed health care needs well by ensuring service users health and wellbeing are properly promoted and protected. Service users have access to health care screening and treatment either in the home or during set appointments at the hospital or surgery. They are satisfied with the levels of support. The service encourages service users to self-medicate if possible, but maintains safe practices for those that prefer medication to be administered for DS0000000862.V343697.R01.S.doc Version 5.2 Page 6 them. Systems are well ‘audit trailed’ for safety of handling medicines. Service users are satisfied with the arrangements for their medication handling, as they prefer not to have the responsibility. The service provides service users with a lifestyle that matches their expectations and facilitates very good links and contact with family and friends. They are also encouraged to exercise choice and control over their lives as much as possible. The service provides appetising and wholesome foods, based on service users’ choices, likes and medical/health diets. There were no comments from service users that implied they were unhappy with the food provision. The service offers good systems for making complaints known and for dealing with them effectively and quickly. It also has robust systems for protecting service users from harm or neglect. The service provides a safe, clean and comfortable environment in which to live, and service users stated they liked their rooms and were happy with the cleaning and decorating arrangements. It ensures there is enough staff with the competence to care properly for service users, and having the required qualifications and experience to do the job. The service make sure service users are well protected by implementing robust recruitment and selection policies, procedures and practice that meet the requirements of the standards and the regulations. A very experienced and qualified manager runs the home very well and according to quality assuring systems that consider all stakeholders’ views. It also assures service users’ financial interests are safeguarded. Finally the service promotes and protects the health, safety and welfare of service users and staff by maintaining good equipment checks, monitoring of work practices and adhering to policies etc. as well as ensuring the relevant legislation is followed wherever possible. What has improved since the last inspection? DS0000000862.V343697.R01.S.doc Version 5.2 Page 7 The service has increased the number of care staff that holds the required qualifications to do the job, to 70 . What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. DS0000000862.V343697.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection DS0000000862.V343697.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6. People who use the service experience good quality outcomes in this area. This judgement has been made using evidence gathered both during and before the visit to the service. Service users have their individual and diverse needs well assessed so they are confident needs will be met. They receive sufficient written information in the form of a statement of purpose and a service users guide so they can decide if the home is the right place for them. EVIDENCE: Service users, staff and manager spoken to and documents seen reveal that service users are fully assessed according to their individual and diverse needs before they are admitted to the home. Assessments are held on file in the form of community care assessment documents and in the form of ‘David Mason Associates’ documents. Where possible service users sign them in agreement. Service users could not all DS0000000862.V343697.R01.S.doc Version 5.2 Page 10 remember the details of their files, and one said, “I don’t remember if I have files in the office. They’re all over the place I think.” Another said, “I know about my assessment and my care plan, I remember them being done.” Assessments had evidence of relatives being involved and were signed. All service users are provided with service user guides, which also contain their individual contract with the home, as well as a copy of the complaint procedure, and are usually held in their rooms. Statements of purpose are also available for prospective service users. Standard 6 is not applicable. DS0000000862.V343697.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8 and 9. People who use the service receive good quality outcomes in this area. This judgement has been made using evidence gathered both during and before the visit to the service. Service users have their health and social care needs well documented in care plans, so they are confident all their needs will be met. They have good opportunities to self-medicate or their medication needs are well managed, and they enjoy good levels of privacy and their dignity is well maintained, so their overall quality of life is good. EVIDENCE: Service users, staff and management spoken to, and service users’ files seen, reveal all service users have a placing authority ‘Community Care’ care plan generated from the assessment form, and a supplemental care plan compiled by the home, using all assessments available. Individual and diverse needs in respect of religion, social activities and physical impairment in particular, are recorded to ensure service users have their individual needs met, and according to their preferences. Care plans are DS0000000862.V343697.R01.S.doc Version 5.2 Page 12 reviewed monthly in the home, and annually with the council and other stakeholders, as well as annually within the home, and all dates are maintained and copies of reviews are held. Service users or their relatives sign care plans. Service users with medical ailments or problems are referred to their GP, and the District Nursing services are accessed, along with outpatient services and treatment. All of these visits are recorded on file. Hearing, sight and dental appointments are carried out as necessary and such as physiotherapy is considered and tried and provided according to need. There is a policy, procedure and practice guidelines on medication administration for staff to follow. Handling and storage of medication is good and a robust medication administration trail is in place and followed. Staff that administer medication have been trained to do so. Medication administration record sheets are signed after giving service users their drugs, from a monitored dosage system. Controlled drugs are recorded in a register, double signed and double locked. Two observations on medication administration are that the person administering it must use medication pots to take the tablets to service users as well as encourage them to only take drugs with water. Service users spoken to are satisfied their medication is handled for them because as one of them put it, “I don’t want to look after my medicines, the arrangements for staff to do it are good.” Another said, “I wouldn’t want to look after my medicines, they are controlled by staff.” Service users spoken to acknowledge they are afforded privacy and dignity with personal care, spending time in their room, seeing visitors if requested, etc. and that they have no concerns over the way their personal care needs are met. One said, “ We are very well cared for, people treat us well. Staff are good and they are kind. I see the chiropodist and have my nails done when I want.” DS0000000862.V343697.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. 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. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. People who use the service experience excellent quality outcomes in this area. This judgement has been made using evidence gathered both during and before the visit to the service. Service users enjoy flexible routines, good contact with relatives and friends, good opportunities to be selfdetermining, and highly satisfying food provision, so they are confident their daily lives and social activities meet their expectations. EVIDENCE: Service users, staff and management spoken to and some documents seen reveal service users lead fulfilling lifestyles of their choosing and preference. There are routines within the home around rising and having meals etc. but individuals can disregarded them if they wish. Service users said they come and go as they please, decide when to rise or go to bed and that they enjoy some level of exercise where possible, but many of them have mobility and cognitive problems. There are opportunities to take part in activities, although these have become repetitive over the last year, and service users made comments on DS0000000862.V343697.R01.S.doc Version 5.2 Page 14 questionnaires that sometimes there are things they like to do, but mostly there are few new things to do. One service user said, “We do activities on a Friday, you can go out to the shops, but I don’t.” Another said, “I like to watch television, especially the football. We also play dominoes and have entertainers in.” According to the provider though interest is often lacking when such as outings are planned. Service users are keen when trips are planned but then loose interest when the day arrives. Contact with family and friends is very good and often facilitated by staff. Maintaining relationships is important in the home and there are regular events that everyone gets to know about. Visitors to the home and staff commented that there is a very family like feel about the home and the relationships are very good. Relatives not only visit their family member but also talk to other service users making the atmosphere friendly, and staff share in all of this too. Relatives visit the home regularly, as seen on the day of the site visit. Documents record all of these activities. Service users and the manager said service users handle their own finances, wherever possible, or family members do. Some service users have a small amount of money held in safekeeping for which individual record books are kept, showing amount in/out, the balance and the signature of the service user. Service users said they are quite satisfied with these arrangements and are pleased they no longer have the responsibilities of budgeting, and cooking or cleaning. All stake holders consulted and making their views known about the home state satisfaction with the food provision. One service user said, “The food is good,” while another said, “The food’s nice.” A relative commented in their questionnaire, “The food is of a high standard.” The lunchtime food provided was seen and consisted of sausage and mash, Yorkshire pudding and cabbage and carrots. Mealtime is a busy but social event with service users congregating in the main dining room and in the ante-dining room just outside. They were observed being engrossed in the meal and afterwards one service user commented she had enjoyed her food. The home also has a tea/coffee station for visitors to help themselves when they call in to see service users. Staff state service users choices are respected and anyone not liking a planned meal is given an alternative. DS0000000862.V343697.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. People who use the service experience excellent quality outcomes in this area. This judgement has been made using evidence gathered both during and before the visit to the service. Service users make use of informal complaint processes and systems and have all issues dealt with appropriately and they do not need to make formal complaints, so service users are confident their concerns are dealt with effectively and efficiently. They also experience excellent promotion and protection of their welfare and so feel confident the systems in place to protect them are robust. EVIDENCE: Discussion with service users, staff and management and viewing of records and documents on complaints and protection issues, reveals service users have good opportunities to discuss issues before they become serious and have them sorted quickly by an understanding and considerate staff group and manager. Service users spoken to are aware of whom to contact if they are unhappy about anything and know their worries will be dealt with quickly and effectively. One said, “If I was unhappy about something and it wasn’t serious I would do nothing to make a fuss, but if it was serious I would just stake someone to a side and tell them. I don’t really know how to make a formal complaint but then I’ve never had to.” Another said, “I would go in the office and see Diane.” DS0000000862.V343697.R01.S.doc Version 5.2 Page 16 All service users spoken to felt they are well cared for and those able to say also commented that those unable to speak up are also well card for. Staff spoken to are aware of the policies and procedures in place and fully understand their responsibilities and the implications of making referrals. They are confident to whistle blow and more confident that the provider will deal with their concerns quickly and appropriately. They also express confidence in going directly to social services if management were unavailable. This staff competence is also indicated in the information taken from staff questionnaires. Policies and procedures are in place and staff know where they are etc. One complaint and one safeguarding adult referral was made in the last twelve months, but only the complaint referred to a situation in the home. The safeguarding adults referral was concerning people outside of the home’s responsibility. Both were appropriately recorded and effectively handled. There is a staffing training matrix kept in the staff room, which shows planned and completed training. Staff undertake complaint training through ‘Skills For Care’ induction and foundation courses and from reading policies and procedures, and do safeguarding adults training with the local safeguarding adults board. This was discussed with the provider and suggested that up-todate training be requested for staff since the changes in safeguarding adults’ protocol. There is also a very good network amongst the staff group, relatives, health care professionals that visit the home and the service users, that ensures everyone looks out for one another. This is an ethos nurtured by the provider/manager, the deputy manager and the senior staff, so that everyone feels they are encouraged to speak up about problems and concerns and have them discussed before they become real problems and complaints. Good communication aids this attitude. DS0000000862.V343697.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. People who use the service experience good quality outcomes in this area. This judgement has been made using evidence gathered both during and before the visit to the service. Service users have a well-maintained, clean and comfortable environment in which to live, so they are confident they have a good home. EVIDENCE: Communal areas of the home were viewed and three rooms were seen with service users’ permission. These are satisfactorily furnished and decorated and are very personalised. The house is suitable for its stated purpose of providing care and accommodation to older people. Service users spoken to are satisfied with the cleanliness of the home, their rooms and the opportunities they have to mix with different people in the lounges and the dining room. Meal times are a social event. One service user DS0000000862.V343697.R01.S.doc Version 5.2 Page 18 said, “The home is kept very clean and so are we.” Another said, “I like it here, the staff are always about and my room’s clean, I do it myself.” The premises are equipped with two passenger lifts, a large mobile hoist and a smaller hoist, as well as one that allows service users to remain standing. There are sliding sheets and turning mats, and ramps to the outside and within the home where levels are different. The home has grab rails in toilets and bathrooms and has recently been awarded a grant to enable the bathroom to be upgraded to meet disability regulations. The home will also be able to purchase some new dining tables and chairs with ‘ski’ style runners instead of legs to aid those service users with poor mobility. There is a rolling programme of redecoration and all maintenance requirements are reported to the handyman, recorded and dealt with as quickly as possible. Staff are aware of and follow the system. The staff state that the cleaners take much pride in the home and always do a good job. DS0000000862.V343697.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. People who use the service experience excellent quality outcomes in this area. This judgement has been made using evidence gathered both during and before the visit to the service. Service users are cared for by wellrecruited, well-trained, confident and skilled staff in satisfactory numbers to meet their needs, so they enjoy an excellent service of care. EVIDENCE: Staff and management spoken to and viewing of documents in relation to staffing numbers, recruitment, training and qualifications reveal all four standards in this section are met. The rosters in the home show there are a minimum of four care staff on each of the two shifts throughout the day and three care staff through the night. There are a total of 602 care hours provided in the home each week and the Residential Staffing Forum requires a minimum of 564.07 per week for 4 high, 12 medium and 11 low dependency level service users. The home is meeting this requirement. All staff left in charge of the home are of an appropriate age and have adequate experience to do so. They are all competent. There are currently 70 of care staff with the NVQ level 2 qualifications and there are another five soon to complete it. Staff spoken to confirm the training and qualifications they undertake. The standard is met. DS0000000862.V343697.R01.S.doc Version 5.2 Page 20 Recruitment of staff follows a recruitment and selection procedure and process and records held in staff files, seen with their permission, contain details required in schedule 2 of the regulations. Systems are robust and protect service users well. Information obtained from discussion and also from files shows staff undertake statutory training in fire safety, first aid, infection control, safeguarding adults, moving and handling, food hygiene, health and safety and medication administration, as well as in other relevant subjects such as dementia, diabetes, incontinence, stroke awareness, etc. The staff group are well trained and skilled in caring for older people. Standard 30 is met. DS0000000862.V343697.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. 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. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. People who use the service experience excellent quality outcomes in this area. This judgement has been made using evidence gathered both during and before the visit to the service. Service users live in a home that is well run and in their best interests, where good systems are in place to determine the quality of the service, and where their financial interests are safeguarded and their health, safety and welfare are well promoted and protected, so they are confident they will be safe and well cared for. EVIDENCE: Discussion with the manager and staff, and viewing of documentation, safety records and certificates reveals, service users and staff benefit from a safe and well-run home. DS0000000862.V343697.R01.S.doc Version 5.2 Page 22 The manager is also the provider and has many years experience in care on a managerial level. She has achieved the Registered Manager’s Award some time ago and is qualified to manage the home. The manager provides an excellent continuity of management and has an open door policy where anyone, service user, staff or relative can discuss issues without fear of recrimination and with confidence that their views will be listened to, taking into consideration and put into action. There is a quality assurance system in operation, which continues to be used in the same way as at the last inspection. The systems were not assessed during this inspection process, but it is understood it includes surveying service users, relatives and health care professionals. The standard is considered met. Service users mostly have their finances managed by their relatives, but all have some money held in the home to cover their weekly expenses for hairdressing, newspapers, sweets etc. The home provides all service users with toiletries, activities and outings and basic needs and does not charge a top-up fee to relatives. The home maintains a record of money in and out, with signatures and running balance for all those that have money held in safekeeping. These records were not seen on the site visit, but service users spoken to explain how the system works and state their satisfaction with it. The Manager maintains a safe environment for service users and staff by ensuring all equipment is regularly serviced and certificated if necessary, by following all relevant legislation in respect of health and safety responsibilities, and by maintaining appropriate records of safety checks, etc. Areas sampled to determine whether or not standard 38 is met are, fire safety, passenger lift and hoist maintenance, water temperature checks and legionella testing, and safety in the use of cleaning substances etc. There is a fire risk assessment document in place, last reviewed July 2006, with a health and safety policy statement in respect of fire safety. Those service users that smoke are listed in the risk assessment document and there are weekly checks on the safety equipment that are recorded. The home holds fire safety drills each month and records maintained for the last six months were seen. All staff undertake mandatory annual fire safety training and both the training matrix and staff training records evidenced this. Preparations to embrace the July 1st smoking ban in public places have been considered and arrangements have now been made. The staff maintain a list of any repairs needed on a weekly basis and these are tackled by the handyman according to his abilities to complete the repairs, otherwise contractors are called in. The home maintains service contracts for the passenger lift and the lifting equipment, and information shows they were last serviced in August 2006 and DS0000000862.V343697.R01.S.doc Version 5.2 Page 23 February 2007 for the lift and January 2007 for the lifting equipment. Staff receive training in using hoists etc. and the most recent was June 2005 and April 2006. This is soon to be updated for everyone. There are regular checks on the temperature of water at various outlets for which a record is maintained, and a legionella test was completed in February 2007. The home holds a file for handling of cleaning products under the safety regulations on substances hazardous to health and staff completes training in both infection control and handling dangerous substances. Cleaners are well aware of the safety issues regarding cleaning products. DS0000000862.V343697.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 4 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 4 17 X 18 4 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 4 X 3 X X 4 DS0000000862.V343697.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? No. STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations DS0000000862.V343697.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Hessle Area Office First Floor, Unit 3 Hesslewood Country Office Park Ferriby Road Hessle HU13 0QF 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 DS0000000862.V343697.R01.S.doc Version 5.2 Page 27 - 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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