Inspection on 11/10/06 for Middlefield Manor Residential Home

This inspection was carried out on 11th October 2006.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 10 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Middlefield Manor Residential... 29/04/08

Middlefield Manor Residential... 04/05/07

Middlefield Manor Residential... 23/05/06

Middlefield Manor Residential... 08/12/05

Middlefield Manor Residential... 12/07/05

Middlefield Manor Residential... 17/11/04

Middlefield Manor Residential... 15/06/04

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Coopers Mill Ltd

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Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Middlefield Manor Residential Home The Street Barton Mills Bury St Edmunds Suffolk IP28 6AW Lead Inspector Claire Hutton Additional Inspection 11th October 2006 10:45 Middlefield Manor Residential Home DS0000024447.V315874.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 Middlefield Manor Residential Home DS0000024447.V315874.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. Middlefield Manor Residential Home DS0000024447.V315874.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Middlefield Manor Residential Home Address The Street Barton Mills Bury St Edmunds Suffolk IP28 6AW 01638 583549 01638 583540 paul.steward@las.org.uk Vanessahalfacre@nas.org.uk National Autistic Society 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) Post Vacant Care Home 15 Category(ies) of Learning disability (15) registration, with number of places Middlefield Manor Residential Home DS0000024447.V315874.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23rd May 2006 Brief Description of the Service: Middlefield Manor is owned by the National Autistic Society (NAS) and is registered to provide personal care for up to fifteen younger adults with a learning disability, specifically, autistic spectrum disorder. The building is a large Georgian detached house set in four acres of grounds, located at the end of a private driveway in the centre of the village of Barton Mills. The home is divided into two separate units; Norfolk House and Cambridge House, each having their own separate enclosed garden and separate staff team. All the homes bedrooms are single with one bedroom benefiting from en-suite facilities. There is no passenger lift to the first floor and no resident accommodated had mobility problems. There is adequate car parking space to the front. Fees for this home range from £1400 to £1800 per week. Middlefield Manor Residential Home DS0000024447.V315874.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced key inspection that focused upon the core standards relating to Adults (18 – 65). It took place on a weekday lasting seven hours. The process included a tour of both Houses Cambridge and Norfolk, discussions with residents and staff, observations of staff and service user interaction, and the examination of a number of documents including residents care plans, medication records, the staff rota, recruitment, training records and records relating to health and safety. The report has been written using accumulated evidence gathered before and during the inspection. Three completed comment cards were received back from relatives/visitors these were generally complimentary, but one person questioned if there were sufficient staff on duty. Five comment cards were received back from the staff group. All of which were positive in their responses, save for two staff who said they did not receive regular supervision. Thirteen completed resident surveys were received back from the current resident group. These were completed with the help of an independent advocate. These too were positive. CSCI are trying to improve the way we engage with people who use services so we gain a real understanding of their views and experiences of social care services. We are currently testing a method of working where ‘experts by experience’ are an important part of the inspection team and help inspectors get a picture of what it is like to live in or use a social care service. Patrick Mc Donagh (Expert by Experience) and his supporter from ‘Barking and Dagenham centre for Independent Living Consortium’ were there for part of this inspection. As a service user Patrick has an expert opinion on what it is like to receive services for people who have a learning disability. Patrick’s comments are included throughout this report where he is referred to as ‘Expert by Experience’. What the service does well: Information is available about this home and the assessments in place are good. There are care plans in place for all residents and are available for use by care staff. The expert by experience said ‘the residents can choose when they go to bed and when to get up. Sometimes they choose to lay-in’. Residents are able to lead an individual lifestyle and opportunities are presented. The expert by experience said ‘One man said he had his own key to the kitchen and his bedroom. One client mentioned they go to college. Another client said they like to go to the cinema. From talking to one of the residents and looking through his photos it seemed he goes out quite a lot to places that he likes’. Middlefield Manor Residential Home DS0000024447.V315874.R01.S.doc Version 5.2 Page 6 Access to healthcare and management of medication is good. Complaints are taken seriously and there is evidence to show these are addressed. The numbers of staff employed at the home and the plan of deployment of staff is good. New staff are well trained. The expert by experience said ‘Staff were nice and happy and welcoming’. What has improved since the last inspection? What they could do better: Middlefield have started off an ambitious process of person centred assessment and review. However the timescales for review have not been consistent for all residents and not in line with national minimum standards. Whilst training for new staff has been good, updates for existing staff has not been consistently achieved. An example of this is Studio 3 training (This is training that Middlefield use for managing behaviour that may be challenging) Out of the five night staff employed only one has a certificate currently in date. Formal supervision of all staff does not meet the minimum stated by standards. This may be a result of an absence in the management team and there should be consideration given to replacing this post. On the day of inspection three people were sick. The manager is trying to manage this situation, but the culture of ‘calling in sick at the last minute’ is proving difficult to solve. The expert by experience commented on the environment and activities at home being areas for improvement: ‘I did not like the colour in the living room and their was no artwork on the walls or stimulation where the TV was. There Middlefield Manor Residential Home DS0000024447.V315874.R01.S.doc Version 5.2 Page 7 were restrictions to the kitchen as it is a locked room. Some residents have a key. It was only staff that seemed to be in the kitchen. One of the seats was broken. And there was also a broken bookcase. The garden shed which was being used as an activity room had a broken radiator and was a bit dirty. The residents were doing nothing in the home, just sitting there. Staff were just sitting in the armchairs talking to other staff members, not really encouraging activity. It was noticed that there were not any activities out or available for the clients to occupy themselves with’. 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. Middlefield Manor Residential Home DS0000024447.V315874.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 Middlefield Manor Residential Home DS0000024447.V315874.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): 1, 2 and 5 Quality in this outcome area is good. Sufficient information is available for prospective service users to decide whether the home will meet their needs. Prospective residents individual aspirations and needs are assessed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Since the last inspection in May 2006 the manager has revised the Service Users Guide and included the arrangements for dealing with complaints. This was seen in one residents file and the manager explained that this easy read format was gone through with the resident. The area that was of interest to one resident was said to be the section on their money. There were contracts seen to be in place and this included the fees payable. The Statement of Purpose also needs to include the arrangements in place for dealing with complaints. No new residents had been admitted to the home since the last inspection, but the home were preparing for a potential residents. The manager had visited a prospective person and had completed an assessment of their needs. He had also obtained information from professionals and was working with the family and an advocate was involved. There would be a opportunity to ‘test drive’ the Middlefield Manor Residential Home DS0000024447.V315874.R01.S.doc Version 5.2 Page 10 home in terms of an trial period. However the introduction was to be planned around the individuals needs and would consist of visits then to move in. The prospective bedroom was being decorated in the prospective residents chosen colours and a new carpet was due to be fitted. Middlefield Manor Residential Home DS0000024447.V315874.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, and 9 Quality in this outcome area is good. Residents, and their representatives can generally be confident that the plans of care maintained at the home reflect and address the individual needs and aspirations of the person concerned. Changing needs may not always be accurately recorded due to delays in reviews. Individual support and choices are promoted from staff. Residents are supported to take risks within a risk assessment framework. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Four care plans and associated records for four residents were examined. Two people from Cambridge House and two people from Norfolk House. There was a care plan in place for each resident based upon person centred planning. The manager explained that they aim to review plans every three months. This had happened in the two of the four cases examined, but in one case a review had not happened in the last six months – a timescale set by the national minimum standards. The care plans were of sufficient detail to give Middlefield Manor Residential Home DS0000024447.V315874.R01.S.doc Version 5.2 Page 12 staff adequate information about the levels of support individuals needed. In one case the plan stated the task and the support required from staff. This was seen to be in place and happening at the time of inspection. The care plans had been developed from the assessments made on individuals. This included risk assessments that were both generic and had individual elements that promoted independence and freedom where possible. Examples included horse riding, swimming, bathing and safety from traffic. The expert by experience reported ‘One resident has a key that gains access to the kitchen, his room and the laundry’. The daily statements made by staff were of good quality and stated what support had been given from night staff, activities undertaken, personal care given and food consumed. The expert by experience said ‘the residents can choose when they go to bed and when to get up. Sometimes they choose to lay-in’. Middlefield Manor Residential Home DS0000024447.V315874.R01.S.doc Version 5.2 Page 13 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): 12, 13, 15, 16 and 17 Quality in this outcome area is good. Residents, and their representatives can be confident that the home enables residents to maintain appropriate lifestyle with individual opportunities and support. Decisions around personal and family relationships are generally respected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The plans examined contained a plan of individual’s day care opportunities. These included onward enterprises, Asdan Courses, dance and movement, hydrotherapy pool and attending old barns. The expert by experience reported ‘One client mentioned they go to college’. In relation to social activities and use of the community the expert by experience reported ‘One resident said he has the choice to have a beer every Middlefield Manor Residential Home DS0000024447.V315874.R01.S.doc Version 5.2 Page 14 now and again if he wants to. Another client said they like to go to the cinema. One client said they go out to nightclubs clubbing. One client had photos and pictures in his room that showed he had been out to various places. It was noticed that there were not any activities out or available for the clients to occupy themselves with’. One comment written by a staff member on a feed back card was ‘some residents get taken out regularly, whilst others do not’. From the three completed questionnaires from relatives all three said they are welcome to visit any time, can meet their relative in private and are kept informed of important matters affecting their relative. One relative who contacted the Inspector said that they were not always kept informed as well as they may wish. The expert by experience reported ‘Friends/relatives are welcome to visit the residents’. One comment written by a staff member on their feedback card was ‘ I think there is to much parental involvement, not allowing managers to manage, they have little knowledge or understanding of the requirements upon us’. In relation to catering, each house shops and cooks independently of each other. The expert by experience said ‘the staff said clients can pick their own meals. They have quite a good choice of what to eat – sometimes roast on Sundays or fish. A resident also said he goes shopping and gets to pick food off of the shelves. One resident does her own shopping – uses the mini bus to go to Tesco. In the second house picture cards were used for the menus, or they ask and are told by staff. They also show foods in freezer and look at the choice. There were restrictions to the kitchen as it is a locked room, some residents have a key’. Middlefield Manor Residential Home DS0000024447.V315874.R01.S.doc Version 5.2 Page 15 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 adequate Residents, and their representatives can expect the home to offer appropriate personal and health care support most of the time, but staff may not always respond quickly in preserving residents modesty. Trained staff appropriately administers medication, and current practice is generally satisfactory. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Care plans set out the support the residents required in relation to their personal care and their physical needs. The daily statements made by staff stated what personal care and support was given to individuals. All thirteen questionnaires from residents were positive about the support offered and residents felt staff listened to them. The expert by experience reported ‘They said they can have a shower or bath, of even both sometimes. One client said that there was no bullying in the home. One of the residents we spoke to was dressed, then went to have a shower and came out with nothing on in the corridor. None of the staff prompted her to get a towel or some clothes. As the expert I thought this was wrong as the person could have been reminded Middlefield Manor Residential Home DS0000024447.V315874.R01.S.doc Version 5.2 Page 16 about putting a towel on as there were male staff and men in the corridor. It seemed by the staff reaction as a normal event’. Care plans recorded all health care and professional visits made. Entries were seen for GP, dentist, district nurse, chiropody and clinical psychology. Medication was on the whole well managed with the home. All staff were adequately trained. Security of medication was appropriate. Medication administration records were seen to have been consistently completed, with the initials of the person administering the medicine recorded on each occasion. Medication for one resident was audited. The policy was available to staff to follow. The record kept of medication returned to the chemist did not always state the name and amount of medication returned. Middlefield Manor Residential Home DS0000024447.V315874.R01.S.doc Version 5.2 Page 17 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. Residents, and their representatives can be confident that the home has appropriate procedures in place to deal with complaints but matters relating to protection of residents from abuse could be more robust. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The complaints procedure for Middlefield Manor is displayed in the front entrance. It is also part of the Service User Guide. In the service users survey it asks ‘do you know how to complaint?’ This was responded to positively in all thirteen cases. Four of the five staff surveyed said they knew how to make a complaint if they needed to. Two of the three relatives surveyed said they also knew how to make a complaint if they needed to. During inspection the log of complaints was examined. This showed that concerns had been received and that the date, complainant and action taken by the home to resolve matters were suitably recorded. The system in place in Suffolk for responding and reporting POVA (Protection of Vulnerable Adults) matters is known and is now being used by the home. There was evidence that staff have received training in recognising and responding to abuse. This is positive as the home has had problems with staff recognising and reporting abusive practices. A number of issues have been reported and investigated over the last year. The protection of vulnerable Middlefield Manor Residential Home DS0000024447.V315874.R01.S.doc Version 5.2 Page 18 services users is therefore an area in which staff and managers need to be vigilant to ensure that service users well being is adequately safeguarded. There is evidence to show that the home do routinely take up CRB checks on staff before they start work at the home. However the evidence available did not identify that they were enhanced checks and that the national POVA list had been checked. Middlefield Manor Residential Home DS0000024447.V315874.R01.S.doc Version 5.2 Page 19 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 and 30 Quality in this outcome area is adequate. Residents, and their representatives can generally expect that the home is comfortable, well maintained and meets the needs of the existing resident group. However further efforts need to be made in relation to repairs and cleanliness of all areas of the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: As you approach Middlefield Manor the change that is noticed is that it has been externally decorated. This has brightened the appearance of the home. The Inspector undertook a full tour of all the premises. The interior communal areas of the home have also been decorated. A shower cubicle had been installed downstairs. However this room was locked, as the toilet was broken. The new shower room still had an ‘industrial’ feel about it from when it was a laundry room and would benefit from furnishings such as curtains etc to make it more homely. The laundry area has been tidied and was clean, however this Middlefield Manor Residential Home DS0000024447.V315874.R01.S.doc Version 5.2 Page 20 door had a notice stating keep locked shut but it was propped open. It was explained that it should be locked, as chemicals were stored there. Most areas of the home were clean, but one shower room and toilet upstairs had not been cleaned for some time. The shower required repair and the toilet required descaling as it was brown in the bottom. A common theme in all the bathrooms was that paper towels were provided to wash hands but there was not waste bin to dispose of them. The expert by experience commented on the environment: ‘Carpets and paintwork seemed quite clean. There was a very big living room, which they could all use with TV, DVD, and sofas. I did not like the colour in the living room and there was no artwork on the walls or stimulation where the TV was. There was a step that was on the way in to the living room that could be quite dangerous – as the expert tripped over it twice. The stairs in the house were very steep. There were restrictions to the kitchen as it is a locked room. Some residents have a key. It was only staff that seemed to be in the kitchen. One of the seats was broken. And there was also a broken bookcase. I didn’t notice anywhere for the residents to sit in their rooms to do any kind of activity. All rooms had a TV. The garden was very nice, had a patio with small benches. The garden shed which was being used as an activity room had a broken radiator and was a bit dirty’. Middlefield Manor Residential Home DS0000024447.V315874.R01.S.doc Version 5.2 Page 21 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): 31, 32, 34, 35 and 36 Quality in this outcome area is adequate. Residents, and their representatives can expect that the home employs suitable numbers of staff that are generally well recruited. However not all staff have up to date training and receive regular supervision. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager has developed a master roster of a seven-week rotation roster that is displayed on the office wall. Each House has ten staff. The roster allows for three staff to be on each shift at all times, but this may drop if not all service users are at the home. The home now employs seven bank staff to try and ensure consistency of carers. On the day of inspection there were three staff off sick. There was a discussion around the culture of some staff to call in sick at the last minute. The manager was trying to resolve this difficult matter. There is currently an absence in the management team at the home and thought should be given to replacing this post. Regular formal supervision is not currently being given to staff as records and feedback from staff show Middlefield Manor Residential Home DS0000024447.V315874.R01.S.doc Version 5.2 Page 22 that the minimum stated in the national standards of six times a year is not being achieved in all cases. The manager was developing a training profile for each member of staff. The manager has planned Mental Capacity Act training for staff in December 2006. There was evidence to show that new staff receive a good induction and training relevant to the role. However long standing staff may not receive updates. An example was the Studio 3 training for night staff. Only one of the five staff currently employed had an up to date certificate. The manager stated that the home employ thirty-two care staff. Seven of these have NVQ 3 in care, six more are working towards their NVQ 3 and two staff are working towards their NVQ 4. This is slightly under the 50 that should be achieved. Recruitment records for three staff were examined. These were in good order save for the comment on CRB’s made under standard 23. Middlefield Manor Residential Home DS0000024447.V315874.R01.S.doc Version 5.2 Page 23 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, 39 and 42 Quality in this outcome area is good. Residents, and their representatives can expect that the home is appropriately managed but matters around health and safety could be further improved. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager of the home has recently undergone the ‘fit person’ process with the Commission. The outcome will shortly be known. The manager has experience of working with adults with a learning disability, specifically those with autism. He is enrolled on the NVQ 4 in Care and the registered managers award. There is an agreed timescale in place for his completion of these qualifications. Middlefield Manor Residential Home DS0000024447.V315874.R01.S.doc Version 5.2 Page 24 In relation to quality assurance the manager spoke of the regulation 26 visits – of which the Commission receives a copy. Regular staff meetings and partnership days were said to be held. He also spoke of the advocacy service that is involved at the home and the action learning sets. In addition there is monthly monitoring of care, human resources, finances and health and safety. Quality assurance and consultation with service users will be further assessed at future inspections. In relation to health and safety with in the home, the laundry door already mentioned should be kept shut and not propped open, as it is a fire door. In the kitchen the freezers should be defrosted as they were frosted up. Cleaning schedules should be developed to prevent this occurring again and be available for inspection. Hot water through out the home is restricted to prevent scalding and this was tested and found to be within safe limits. Middlefield Manor Residential Home DS0000024447.V315874.R01.S.doc Version 5.2 Page 25 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 2 2 3 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 3 23 2 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 3 32 2 33 X 34 3 35 2 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 2 X Middlefield Manor Residential Home DS0000024447.V315874.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? Yes 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 YA1 Regulation 4Schedule 1 Requirement The Statement of Purpose must be revised to include the arrangements for dealing with complaints. (This is a repeat requirement) The service users plan must be regularly reviewed, minimum six monthly, to ensure the changing needs are accurately reflected. The registered persons must ensure that service users are safeguarded from abuse, through deliberate intent, negligence or ignorance, in accordance with written policy. Communal areas, including, shower room, bathrooms and WC’s need to be made more homely. (This is a repeat requirement.) The premises and equipment provided must be kept in a good state of repair. See report for details. The premises must be kept clean DS0000024447.V315874.R01.S.doc Timescale for action 04/12/06 2. YA6 15 (2)(b) 04/12/06 3. YA23 13 (6) 04/12/06 4. YA24 23 04/12/06 5. YA24 23 04/12/06 6. YA30 13 (3) 04/12/06 Page 27 Middlefield Manor Residential Home Version 5.2 7. YA34 19 and hygienic throughout. See report for details. A record must be kept of all CRB checks undertaken, and their result. Evidence of appropriate supervision and appraisal arrangements must be made available for inspection. (This is a repeat requirement) 04/12/06 8. YA35 18 (1) The registered person must 04/12/06 ensure that there is a staff training and development programme which meets the Sector Skills Council workforce training targets and ensures staff fulfil the aims of the home and meet the changing needs of service users’. This must include updates in specialist training such as Studio 3. Staff must receive the support and supervision they need to carry out their jobs. The registered manager must ensure so far as is reasonably practicable the health, safety and welfare of service users and staff. Therefore fire doors must not be propped open and cleaning schedules should be developed. 04/12/06 04/12/06 9. 10. YA36 YA42 18(2) 13 (4) 23 (4) 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 YA9 YA12 Good Practice Recommendations Incident forms should be completed, and simplified by using names and specific references. The opportunities and activities ‘in house’ should be DS0000024447.V315874.R01.S.doc Version 5.2 Page 28 Middlefield Manor Residential Home reviewed. 3. YA16 Locked doors throughout the home should be reviewed and assessed in terms of each individuals rights to choice and freedom of movement as well as their safety. The record of medication returned to the chemist should include the name and amount of medication. The record to evidence CRB checks should include that the check was enhanced and that the national POVA register was consulted. Consideration should be given to replacing the absence position in the management team. 4. 5. 6. YA20 YA23 YA34 YA31 Middlefield Manor Residential Home DS0000024447.V315874.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Suffolk Area Office St Vincent House Cutler Street Ipswich Suffolk IP1 1UQ 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. 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