Inspection on 29/04/08 for Middlefield Manor Residential Home

This inspection was carried out on 29th April 2008.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Middlefield Manor Residential... 04/05/07

Middlefield Manor Residential... 11/10/06

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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Pemdale

Extracts from inspection reports are licensed from CQC, this page was updated on 28/09/2008.

CARE HOME ADULTS 18-65 Middlefield Manor Residential Home The Street Barton Mills Bury St Edmunds Suffolk IP28 6AW Lead Inspector Claire Hutton Unannounced Inspection 29th April 2008 10:10 Middlefield Manor Residential Home DS0000024447.V363453.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.V363453.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.V363453.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 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) Vanessahalfacre@nas.org.uk National Autistic Society Manager post vacant Care Home 15 Category(ies) of Learning disability (15) registration, with number of places Middlefield Manor Residential Home DS0000024447.V363453.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Date of last inspection 4th May 2007 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 have mobility problems. There is adequate car parking space to the front. Fees for this home range from £1300 to £2400 per week. Information regarding the service can be obtained from the Statement of Purpose and Service User Guide available from the manager. A copy of the recent CSCI inspection report is also available in the home. Middlefield Manor Residential Home DS0000024447.V363453.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use the service experience good quality outcomes. This was an unannounced key inspection that focused upon the core standards relating to Adults (18 – 65). The site visit took place on a weekday lasting 9 ½ hours. The inspection process included visiting all areas of the home, discussions with staff and residents, observations of staff and resident interaction, and the examination of a number of documents including resident care plans and associated documents, medication records, the staff rota, records relating to health and safety and records relating to staff recruitment. The report has been written using accumulated evidence gathered before and during the inspection. The Commission had received an Annual Quality Assurance Assessment (AQAA) completed by the new manager before the inspection. This completed document is a self-assessment. Three completed surveys were received back from relatives before the inspection. These were all positive. Two completed surveys were also received back from staff before the inspection. One survey was more positive than the other. Therefore to get a clearer view 2 staff were interviewed in private during the inspection. No completed surveys were received back from the resident group therefore 2 pictorial surveys were completed by two residents during the visit to the home. These were positive. Comments received by people who use this service are used throughout this report. Since the last inspection of this service the registered manager has resigned and a temporary manager has been appointed. The National Autistic Society are currently recruiting a permanent manager for the home. What the service does well: Prospective people who use this service can expect to have information available about the service on offer and to have their needs assessed before they move in this will ensure the service can meet their needs. People are provided with a contract and agreements are established. The home enables residents to maintain an appropriate lifestyle with individual opportunities and support. All the feedback from residents was positive about this. One resident told us ‘I’m happy ay Middlefield Manor and I like the staff’. Residents are aware of how to complain and feel that they were listened to. Middlefield Manor Residential Home DS0000024447.V363453.R01.S.doc Version 5.2 Page 6 Middlefield Manor is a clean and comfortable home, very spacious with large enclosed grounds. The new refurbishment of the bathrooms, showers and Cambridge kitchen has added a better quality of accommodation available for residents use. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Middlefield Manor Residential Home DS0000024447.V363453.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Middlefield Manor Residential Home DS0000024447.V363453.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3 and 5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Information is available so that prospective service users can make an informed choice. People are provided with a contract and therefore agreements are established. EVIDENCE: The home has a Statement of Purpose and a Service Users Guide. The Statement of Purpose sets out the admission criteria for the home. Copies of these documents had been given to current residents and were seen on their individual file. The complaints procedure is part of these documents and is in a pictorial format to aid understanding. The self-assessment states ‘The Statement of Purpose has also been revised to include the arrangements in place for dealing with complaints. All new people have a complete assessment of their needs, which includes information from families, professionals and advocates. There is an opportunity for a trial period. Everyone has a contract’. There have been no new admissions to the home since our last inspection, therefore we have not been able to inspect new assessments carried out; but we know that assessments have previously been completed prior to anyone Middlefield Manor Residential Home DS0000024447.V363453.R01.S.doc Version 5.2 Page 9 taking up residence at this home, with care and support needs having been assessed and agreed to be met by the home. We examined 2 files that contained contracts in place for residents and these set out the terms and conditions. All three relatives tell us that the home provides enough information to help them make decisions. Middlefield Manor Residential Home DS0000024447.V363453.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 and 9. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff do not have access to up to date information so that they can support people appropriately. Residents are assisted to make everyday decisions. EVIDENCE: The care plans and associated documentation for 2 residents were examined in detail, one from each house. The first care plan showed that there were clear instructions available to staff on how best to support the individual. However this did not include some recent incidents that were recorded around behaviour. The current documentation had been reviewed in June 2007. However this should be reviewed at least every six months or when change occurs to reflect the up to date situation. Feedback was given to the manager that this individual needed a behavioural support plan based upon the recent incidents and changes in behaviour to ensure the support given by staff was consistent and up to date. Middlefield Manor Residential Home DS0000024447.V363453.R01.S.doc Version 5.2 Page 11 Documentation was being completed on behavioural incidents and staff spoken with knew how to complete these, but reflective practice was lacking to ensure a consistent approach that would benefit people with autism. The same person had daily records duly completed by staff about personal support given, meals offered and eaten and activities they had participated in. The details and information on the front sheet for this person identified a keyworker who had left employment a long time previously – these and other details such as GP and dentist should be updated to ensure only correct data and information is used and passed on where necessary. The care planning information in place for one other individual was also discussed with the manager. There was a person centred plan that had been developed, but as this had not been dated we were unclear as to whether this was still relevant. There was evidence that a formal review had taken place with the funding authority and that a further review had taken place in house amongst staff and this had clear documentation that had relevant action plans in place. However it was unclear as to how all these separate documentations related to one another and which documentation staff should be currently following. The manager did explain that they were working to enhance the liberty of 2 residents in relation to offering them door keys. The restriction of freedom of residents was discussed with the manager and wherever this occurs for safety reasons then it should be documented in the care planning. This is particularly relevant in terms of locked doors. The risk assessments in place were examined. These were quite generic and each one appeared to be repeated in each file though may not be relevant. These were discussed with the manager along with the statement that was written in the self-assessment that said ‘the home operates a policy on positive risk taking’. The new managers understanding on risk taking was that residents should be supported to take risks to enhance their life experience, however the risk assessments in files were not as individual as should be and were not up to date. One risk assessment examined was dated 2003. There was evidence that residents did make decisions about everyday activities. Resident choice was respected when offering activities and this was seen on the day of the visit in attending or declining the activity on offer. Daily records also documented choices offered and made. In the resident survey we asked ‘Are you involved in making decisions in your home?’ Both people responded yes to this. One resident explained they had chosen the colour of their shower room when it had recently been decorated. There was also evidence that residents decided their choice of food, with one resident choosing a specific breakfast – ‘just how I like it’. Three relatives said they feel the home meets the needs of their relative. Middlefield Manor Residential Home DS0000024447.V363453.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,14,15,16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Appropriate opportunities for leisure and personal development were offered and met the needs of the resident group. People enjoyed a varied diet. EVIDENCE: In terms of activities and choices available to residents there was a great variety on offer. Staff have access to the weekly program for the residents in their house. A staff member confirmed that this was regularly updated if anyone’s needs or choices in activities changed. The program shows courses available from the college in pottery, computers and performing arts. There is horse riding, shopping, lunch preparation and a place called onward enterprises that is a sheltered employment. One person chose not to attend any day services and their decision was respected, but offers from time to time were made of different activities. Staff said that if an offer is taken up then they ensure staff are available to support that individual. The two individuals Middlefield Manor Residential Home DS0000024447.V363453.R01.S.doc Version 5.2 Page 13 who completed their survey confirmed that the activities available were good. The self-assessment states ‘we maintain and continue to develop peoples personal lifestyles, opportunities and support. Decisions around personal and family relationships are respected. Community participation and involvement is achieved with the support required by that individual person’. One relative told us ‘we are very happy that our relative is at Middlefield Manor. The care staff take our relative to the cinema, theatre, swimming and long walks. Our relative loves all this. Our relative takes part in cooking sessions that are particularly enjoyed’. Three residents are preparing to go on holiday to Wroxham and are to stay in a self-catering chalet with staff support. Care staff were seen to be preparing fresh vegetables for the evening meal. It was explained that residents make a choice in an evening for what they would like as their main meal the next day. There were menus available that gave residents a choice. On the day residents could choose between beef stew, salmon or chicken. The choice of vegetables was cauliflower, courgette, leeks and broccoli. There was also salad available. The manager explained that they were in the process of developing a pictorial menu to develop communication. This involved taking pictures of meals that had been prepared for residents to choose again if they had liked them. Both residents in the survey said they liked the food at Middlefield Manor and that choice was available. The survey from the three relatives said that the home always helped them to keep in touch. Records showed that regular contact by telephone is made and relatives can regularly visit if they so wish. One relative said ‘whenever we go to visit we are met at the station and then we usually have a long lunch together. We and the carers have a weekly chat on the telephone’. Middlefield Manor Residential Home DS0000024447.V363453.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People were supported in a manner suited to their personal preference. Medication practices were generally effective to protect people. EVIDENCE: The self-assessment completed by the manager tells us ‘Documented health appointments include dental, opticians, chiropdy, psychology and psychiatry. Each person in the Home has a OK helath check this is reviewed each year. The individual that also requires further input may see a psychologist / psychiatrist every 6 months for medication reviews. There are visits from reflexologist, massage therapist’. All these points were clarified and documentation seen during the visit confirm all these services are avaiable to residents at Middlefield Manor. The health records relating to one individual who had been unwell recently were examined. Appropriate emergency and ongoing medical attention had been sought with a referral to a neurologist. Where an individual had eplilepsy recording was good and the managers knowledge was excellent. Additional Middlefield Manor Residential Home DS0000024447.V363453.R01.S.doc Version 5.2 Page 15 support and training in this area had been given to staff to enhance the support avaiable to the individual resident. The two residents who completed their survey said that staff treated them well and respected their privacy. Staff spoken with were aware of how to promote privacy and dignity. One staff member said I always ensure doors are closed when supporting residents – cover them with a towel’. Another staff member said ‘It is about a culture we promote in how we speak to residents in a respectful way. We can support in educating the residents to do as much for themselves as possible’. In relation to medication management within the home, the self-assessment tells us: ‘All staff are trained to dispense medication, through training with Boots pharamacy and in house observations. Risk assesments for medication administration are in place. The home use a monitored dosage system to enable safe administration of medication’. The systems in place for medication management were examined in Norfolk House. There is a policy and procedure avaiable for staff to follow. There are photographs of each resident to ensure the correct resident get their medication. There were sample signatures of staff to verify who had administered certain medication should the need arise. The medication administration sheets were completed and the codes were used – therfore the documentation is being used correctly. One residents medication was audited and found to be correct. One medication administration sheet had been written by hand by a staff member. This handwritten instruction on the medication administration record did not correspond with the policy. The medication in stock did not match that identified on the hand written records. These practices are placing both the resident and staff at risk. Middlefield Manor Residential Home DS0000024447.V363453.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are protected and their views listened to. EVIDENCE: The self-assessment completed by the manager tells us ‘we continue to maintain an effective relationship with parents and families, and there is a mutually respectful relationship and positive dialogue. The protection of vulnerable adults remains a high priority for the service. The home also ensures that complaints that are received in a variety of formats are addressed in line with the companies and CSCI time scales, the issues of complaints has been addressed through the manager having regularly contact with all families carers and service users, allowing the discussion to arise which has reduced the problems developing’. The complaints procedure is displayed at the home for anyone to see. Each resident has been given a copy of a pictorial complaints procedure and a copy of this is in resident files. Two parents spoken with say that the relationship with the manager of the home is good and feel that he is approachable. The three parents who completed the survey said they did know how to complain if the need arose. Two staff spoken with were asked how they would make sure residents knew how to complain if they needed to. One said ‘I would go through the procedure with them that is on the wall and facilitate them expressing themselves’. The other member of staff said ‘I would guide them to a senior or get the manager to speak with them’. The two surveys completed by the residents said that they did know who to speak to if they Middlefield Manor Residential Home DS0000024447.V363453.R01.S.doc Version 5.2 Page 17 were unhappy. The log of complaints was examined and the last recorded complaint received by the home was March 2006. This had been looked into and resolved. With regard safeguarding of the residents, the home has a safeguarding procedure in place and the manger is aware of how to appropriately make referrals using the local procedures. The last referral made was discussed with the manager. This has been appropriately dealt with by the home and the matter was now drawing to an appropriate close. Two staff spoken with both confirmed they had received training in safeguarding and were quite clear of what their responsibility would be if they became aware of any potential abuse matters. The survey completed by the two residents asks them ‘do you feel safe here’, both of the residents had responded yes. The record of the training matrix at the home confirmed that all staff had received safeguarding training. Middlefield Manor Residential Home DS0000024447.V363453.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Middlefield Manor is comfortable, well maintained and meets the needs of the existing resident group. EVIDENCE: The self-assessment completed by the manager tells us ‘a program of redecoration continues, all bathrooms have/are being replaced and modernised. Several rooms have been redecorated within the home’. A tour of the home was conducted and found these improvements are positively underway. These developments improve the quality of accommodation available to the residents. There were formal agreements in place with the contractors who were undertaking the refurbishment work with risk assessments in place to ensure the safety of residents whilst work was taking place. Middlefield Manor Residential Home DS0000024447.V363453.R01.S.doc Version 5.2 Page 19 The whole home makes a large establishment and at the last visit to the home we were told a cleaner came in once a week to clean all of downstairs. This is no longer the case. Care staff have cleaning schedules that are drawn up for both day jobs and weekly jobs to ensure the houses stay clean and that beds are changed regularly. These schedules were examined and found to be systematically completed. Everywhere was seen to be clean and fresh. The laundry room has all the appropriate equipment, and the wash hand basin to wash hands is accessible with liquid soap and paper towels available to use. The self-assessment also tells us ‘All windows on the first floor have restrictors on them to ensure individuals safety’. The maintenance book was examined and this showed that repairs required are reported to the homes handyman and promptly dealt with thereby ensuring the premises are maintained and kept safe. Middlefield Manor Residential Home DS0000024447.V363453.R01.S.doc Version 5.2 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 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34,35 and 36. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There were sufficient well-recruited staff that are appropriately trained, therefore residents are well supported. EVIDENCE: The self-assessment completed by the home tells us ‘staffing levels are based upon the Residential Forum Guidance, and we have increased our staff bank team and are able to cover annual leave/sickness with consistent and trained staff’. The roster in use at the home was examined and this showed sufficient staff are consistently on duty. Each house has 3 staff on duty during the day and at night there are 2 staff awake. However currently the home needs to use agency staff to meet this level of staffing. The manager confirmed that recruitment is underway. Further staff are leaving because they are planning to work with residents who are moving to more independent living. The residents are aware of who is on duty as there is a staff photo displayed of each staff member on duty that day. Middlefield Manor Residential Home DS0000024447.V363453.R01.S.doc Version 5.2 Page 21 Recruitment records for 3 staff were examined and these found that background checks were completed in line with regulation therefore provide the safeguards to offer protection to people living at the home. In 2 cases examined there was no proof of identity available to examine, but these must have been provided at some point to process the criminal records bureau (CRB) checks that were present. The self-assessment tells us that 9 staff hold an NVQ qualification in care with a further 11 staff working towards the qualification. Staff spoken with and surveys completed confirmed that the employer carried out checks such as CRB and references before starting work. Staff confirmed that they had appropriate training to do their job. One staff member said that ‘a cultural awareness course could be introduced to enable all staff to meet the demands of the individuals e.g. if a client is a Muslim’. The staff training matrix confirmed that staff are well trained. Training planned for May and June includes fire training, Studio III (dealing with behaviour that challenges) a 3 day medication course, epilepsy, and 2 staff are planning to attend a person centred planning training course. The supervision records examined showed that these were currently behind schedule and that staff were not receiving formal supervision at regular intervals. Middlefield Manor Residential Home DS0000024447.V363453.R01.S.doc Version 5.2 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 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. This judgement has been made using available evidence including a visit to this service. Middlefield Manor is well managed. The health, safety and welfare of people using this service is being promoted. EVIDENCE: Since our previous visit to the home we were informed that the registered manager had resigned and the National Autistic Society had appointed an interim manager. The new manager is appropriately qualified. The manager is available at the home from Tuesday to Thursday each week as their substantive post was nearer to London. Staff spoken with are satisfied overall with the new management arrangements. Staff said the new manager was approachable and ‘upfront’ with his management style, but one staff member believed the manager should be available for support at the home full time and not part time. Another member of staff said ‘the manager is very supportive Middlefield Manor Residential Home DS0000024447.V363453.R01.S.doc Version 5.2 Page 23 and handles any problems or issues quickly and positively’. Two relatives spoken to say the new manager is approachable and are satisfied with their dealings with him. The permanent manager post is currently being advertised. In November 2007 the National Autistic Society completed an audit and quality assurance visit at the home that lasted 2 days. The results of this were available for inspection and clearly set out the improvements with timescales for implementation that the organisation intend to bring about within this service. In addition the organisation regularly visit the home and complete a report (called a regulation 26 report) that seeks the views of the residents and staff. In relation to health, safety and welfare of the residents training records show that staff have undergone training in health and safety, 1st aid and food hygiene training. In touring the home we found that chemicals were appropriately locked away and that staff has access to equipment such as aprons and gloves to maintain hygiene standards. Hot water was tested in a refurbished bath and shower and these were found to be within safe limits that would not harm residents. In March this year the home had an inspection by the environmental health department. The manager confirmed that he had revised environmental risk assessments as a result of the visit. Within the home they operate the safeguards set out in the food safety package entitled ‘better food safer business’. Middlefield Manor Residential Home DS0000024447.V363453.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 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 3 2 3 3 3 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 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 1 3 X 2 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 3 X X 3 X Middlefield Manor Residential Home DS0000024447.V363453.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. 1. Standard YA6 Regulation 15 Requirement All care plans must be regularly reviewed, especially when needs change. An up to date care plan will ensure staff can give consistent and appropriate care and support to each individual resident. The home’s medication policy or current practice must be reviewed to find a safer way for staff to alter medication administration records. The current practice is placing residents and staff at risk. Timescale for action 28/06/08 2. YA20 13 28/06/08 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 YA6 Good Practice Recommendations Risk assessments should be based upon individual circumstances and linked to care plans. Care planning documentation was confusing and should be DS0000024447.V363453.R01.S.doc Version 5.2 Page 26 Middlefield Manor Residential Home 3. YA36 reviewed. Documentation should be made accessible to the resident group. This active participation that aims for involvement of residents will also ensure staff have a clear understanding. Staff should be offered regular formal supervision to ensure they carry out their job appropriately. Middlefield Manor Residential Home DS0000024447.V363453.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 Middlefield Manor Residential Home DS0000024447.V363453.R01.S.doc Version 5.2 Page 28 - 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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