Inspection on 04/05/07 for Middlefield Manor Residential Home

This inspection was carried out on 4th May 2007.

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 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... 29/04/08

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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Upaya Ananda

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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 Key Unannounced Inspection 4th May 2007 10:10 Middlefield Manor Residential Home DS0000024447.V335273.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.V335273.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.V335273.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 paulsteward@nas.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) Paul Steward Care Home 15 Category(ies) of Learning disability (15) registration, with number of places Middlefield Manor Residential Home DS0000024447.V335273.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The registered manager will complete NVQ 4 in Care by November 2006. The registered manager will complete the registered managers award by February 2007. 23rd May 2006 Date of last inspection 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 £1900 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.V335273.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place on a weekday afternoon. This was a key inspection, which focused on the core standards relating to Adults (18 - 65). The manager was on duty to help with the inspection. The inspector was given a tour of both Cambridge and Norfolk House and spoke with some of the residents, and the staff, both individually and in a group. The inspector also examined care plans, staff records, maintenance records and training records. A questionnaire survey was sent out by the Commission to residents, staff and to relatives before the inspection took place. Ten residents responded, ten staff and nine relatives. Their answers to the questions and any additional comments have been included in the appropriate sections of this report. The management also completed an Annual Quality Assurance Assessment (AQAA) form and dataset. Due to time constraints this was returned after the inspection. Information from these documents has been used in this report after verification. This report has been delayed due to circumstances beyond our control. 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. One relative said “There seems to be a commitment to person centred planning”. Residents are able to lead an individual lifestyle and opportunities are presented. Holidays had been taken and others were planned. The advocate wrote on the behalf of one individual “This person has a very active life”. Access to healthcare and management of medication is good. Complaints are taken seriously and there is evidence to show these are addressed. Seven out of eight relatives who responded were aware of how to make a complaint. One could not remember. The numbers of staff employed at the home and the plan of deployment of staff is good. New staff are well trained. Middlefield Manor Residential Home DS0000024447.V335273.R01.S.doc Version 5.2 Page 6 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.V335273.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.V335273.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, 4 and 5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents can be assured that they will have sufficient information to decide if this home is where they wish to live. The home will also collect sufficient information to assure the person that their needs can be meet. EVIDENCE: Whilst tracking information on residents it was noted that the Service Users Guide was in files. Part of this is in pictorial easy read format. The inspector had previously been told that this was gone through with residents. Contracts were seen to be in place for individuals. No new residents had been admitted to the home for some time. The home ensures that only people compatible with the existing residents are admitted. This was tested through planned visits and the manager had visited a prospective person and had completed an assessment of their needs. He had also obtained information from professionals and had worked with the family and an advocate was involved. However this individual did not move to the home and therefore is still one ongoing vacancy. Middlefield Manor Residential Home DS0000024447.V335273.R01.S.doc Version 5.2 Page 9 From the ten resident surveys returned all ten responded positively to the questions ‘Where you asked if you wanted to move to this home’ and ‘Did you receive enough information about the home before you moved in. Most of these decisions were said to have taken place with parental support. One resident said “I like it here, it’s the right place for me”. The completed AQAA stated ‘Our Service User Guide has been revised by the manager; this includes the arrangements for dealing with complaints. Everyone has a contract. 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. People are encouraged to personalise their own room and take part in choosing colour schemes for communal areas.’ Middlefield Manor Residential Home DS0000024447.V335273.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, 8 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can be assured that their health, personal and social care needs are set out in an individual care plan. They are able to contribute to the development and review of their care plans, with their views and needs taken into account, to ensure they receive the appropriate personal, health, and social care. EVIDENCE: Care plans evidenced that the home actively promoted resident involvement in assessments and reviews and consulted families and other professionals as appropriate. Records also included detailed information about the individual’s history, circumstances, communication needs, likes/dislikes and support networks. The care plan and associated records for two individual were examined (one resident from either house). They were detailed and included the individual’s Middlefield Manor Residential Home DS0000024447.V335273.R01.S.doc Version 5.2 Page 11 goals and aspirations, and who was responsible for actioning and resourcing the means to meet them, support plans, daily routines and weekly programmes, personal care needs, health needs, communication profile. The daily statement recorded by the staff was a clear account of how the individual had spent their time, which staff had supported them, nutritional intake, the resident’s general mood and any personal support given. In care plans were risk assessments, these appeared to be the same in each persons file. These related to matters such as safety around roads, the use of the minibus and use of the grounds. The review of some of these was as far back as 2004 and 2005. There were no risk assessments linked to individual plans of care. The AQQA completed by the manager stated ‘Everyone now has a person centred plan, and the achievements that individuals have made. We have also developed a two day Person Centred and Thinking development programme that all our staff attend.’ In the section relating to these standards about what they could do better the manager reports ‘ We are making risk assessment more enabling and person centred’. From the residents surveys returned all residents responded positively to the question ‘Do you make decisions about what you do each day. One resident said “Yes I do”. The advocate had written in those residents surveys who were non verbal that staff worked with them in a person centred way and were able to communicate and understand the residents. In the relatives survey eight relatives responded positively to the question ‘Does the care home give the support or care to your relative that you expect or agreed. One relative commented, “Often when I phone, the member of staff doesn’t know my relative and they have to find someone who does”. A different relative wrote, “The staff work very hard under difficult circumstances especially when they are short staffed. My relative has remained safe for a long time now, which to me is the most important thing”. Middlefield Manor Residential Home DS0000024447.V335273.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): 12, 13, 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. Residents are being offered a choice of activities to meet their needs and aspirations. They are supported to maintain family and other contacts. A choice of nutritional meals is provided. EVIDENCE: Not all the residents were at home at the time of the inspection. Individuals were doing different things during the day. There was one person out at pottery classes, one person swimming, two people planning to go out for a drive and a walk, one person at work experience and one person horse riding. Two other residents were planning a holiday in Norfolk. The staff member confidently went through all the plans that had been put in place for the holiday. Other holidays that were planned or had taken place included destinations such as Wroxham, Blakeney, Dublin, Ibiza and Butlins. One person was planning a trip to Africa next year. Middlefield Manor Residential Home DS0000024447.V335273.R01.S.doc Version 5.2 Page 13 Staff had access to a weekly schedule that set out what residents did which activities on each day. The program included aspects of independent living skills as well as use of community facilities such as the cinema and lunch out. In the relatives questionnaire all relatives responded positively to the question ‘does the care home help your relative keep in touch with you.’ One relative wrote “Middlefield Manor has a very good record in this respect. Christmas and birthday cards are sent to my mother, and flowers on Mothers day. The staff are very helpful with regards visits and I can usually speak to my relatives key worker regularly for updates”. Another relative wrote “I receive a phone call once a week with a report on activities from the staff on duty in house, my relative is encouraged to speak on the phone”. In relation to catering, each house shops and cooks independently of each other. Residents are involved in this process. There were good food stocks in each house to offer choice to residents. The home ensures one resident has halal meat to meet their cultural needs. Middlefield Manor Residential Home DS0000024447.V335273.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. Health needs are assessed and reviewed regularly to ensure that residents are properly cared for. The medication procedures in place ensure that residents are safe. 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. Response from the relative questionnaire when asked ‘Does the care service meet the needs of people?’ showed eight relatives responding positively. One relative said, “Person centred planning has proved a useful initiative in this direction”. Another relative wrote “I believe the staff do make every effort to maintain notes… apart from being important for new members of staff, also ensures continuity and a happy environment which are important”. One relative thought that only sometimes was the service able to meet the different needs of people. Comments included “Some staff are very good, others haven’t a clue”. Middlefield Manor Residential Home DS0000024447.V335273.R01.S.doc Version 5.2 Page 15 Care plans recorded all health care and professional visits made. Entries were seen for GP, dentist, optician, chiropodist and well woman clinics. Where appropriate records were kept relating to epileptic seizures. Training records showed that most staff had undertaken First Aid training in recent months. Medication records were also examined during the inspection. The home used a monitored dosage system and individual’s records were clearly identifiable by their name and were clear, complete, and appropriately signed and dated. Medication that is not consistently prescribed (as and when medication) is now only used for one individual. Staff spoken with about the medication administration procedures and were found to be confidant and confirmed they had received training and supervision. One member of staff was due to attend a six-day course on medication training. The medication was seen to be appropriately stored in locked cabinets. The manager stated as evidence of what they do well in the completed AQAA: ‘Documented health appointments including dental, opticians, chiropdy, psychology and psychiatry. All staff are trained to dispense medication, through training with Boots and in house observations’. Middlefield Manor Residential Home DS0000024447.V335273.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. Residents can be assured that their views will be listened to, taken seriously and acted upon. There are proper policy and procedure in place to deal with complaints and safeguarding adults from abuse. 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 who to speak to if you are unhappy’. Six residents had responded ‘Yes’. Four residents had responded ‘No’, but the advocate had gone on to explain that even though these residents could not speak they could express unhappiness through body language and facial expression. All ten staff surveyed were aware of the homes complaint procedure. From relatives eight people said they knew how to make a complaint if needed. One relative could not remember. One relative commented, “Yes I do but it makes little difference”. A different relative wrote “Sadly the manager treats all questions or parents concerns in a very defensive attitude, and will be challenging and will intimidate”. In the AQQA the manager stated that what they have done well is ‘We have developed our relationship with parents and families, and there is now a mutually respectful relationship and positive dialogue. We have also raised Protection of Vulnerable Adults as a key priorty and staff have received training Middlefield Manor Residential Home DS0000024447.V335273.R01.S.doc Version 5.2 Page 17 for this. This is also a main agenda item at the house meetings, together with dignity and respect.’ The log of complaints was examined. No new complaints had been received since the last inspection in November 2006, which had showed those, had been logged and investigated. The system in place in Suffolk for responding and reporting Safeguarding Adults (Protection of Vulnerable Adults) matters is known and used by the home. There was evidence that all staff have received training in recognising and responding to abuse. There was a case during inspection that the manager updated the inspector about. There is evidence to show that the home do routinely take up CRB checks on staff before they start work at the home. These were said to be re-done every three years in line with good practice. Middlefield Manor Residential Home DS0000024447.V335273.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 adequate. This judgement has been made using available evidence including a visit to this service. Residents, and their representatives can generally expect that the home is comfortable, well maintained and meets the needs of the existing resident group. However the environment and practice could be made safer and thereby offering a better assurance to people. EVIDENCE: Environmentally there has been work to develop the home in terms of repair and decoration. A good deal of work has been undertaken such as in Norfolk House the kitchen has been deep cleaned and new work tops have been put in place. Retiling for this kitchen is planned. The lounge in Norfolk continues to feel and look comfortable and homely. In Cambridge House the lounge area does feel more comfortable and homely than it did, but this is still a work in progress. There are plans to refurbish the kitchen and shower room in Cambridge House to make this a better quality and for the shower room to promote privacy and dignity. Middlefield Manor Residential Home DS0000024447.V335273.R01.S.doc Version 5.2 Page 19 The laundry room had all the appropriate equipment, however the wash hand basin to wash hands before leaving the room was inaccessible due to buckets and boxes that barred the way and well as no liquid soap or paper towels available to use. All communal areas were visited along with a few bedrooms with residents consent. Everywhere was seen to be clean and fresh. The whole home makes a large establishment and the inspector was told a cleaner came in once a week to clean all of downstairs. 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. Two bedrooms were visited that did not have restrictions on the windows. These windows were 2 meters above ground level and were freely accessible to residents. Middlefield Manor Residential Home DS0000024447.V335273.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. The procedures for the recruitment of staff are stringent and provide the safeguards to offer protection to people living in the home. The deployment and number of staff available at all times of day was sufficient to meet the assessed needs of residents. EVIDENCE: On the day of inspection there were two residents away from the home visiting with family. There were two staff in one house and three staff in the other. The home had decreased their usage of agency staff and had been able to staff the home based upon the activities and needs of the residents with their own bank staff. The month’s roster was displayed on the office wall. Seven out of the ten staff surveyed believed that the current staff level was sufficient to meet the needs of the residents. One staff member explained their negative response to this question as “most often lack of drivers and people of sick”. One staff member had indicated yes and no and went on to say “not when there is insufficient staff to do 1 –1 with some of the service users”. Middlefield Manor Residential Home DS0000024447.V335273.R01.S.doc Version 5.2 Page 21 All ten staff were positive and said yes the home does have a good training and development program to support staff. In individual files examined there were certificates for medication, Studio 3, First Aid, Safeguarding Adults, epilepsy, health and safety – including fire and basic food hygiene. These courses for staff with dates were seen on the training program for the home. For the Service Coordinators there was additional management training taking place with both of the people doing NVQ 4. In relation to care staff eleven people were registered on NVQ 3 and five had already achieved this qualification. The recruitment records for three staff were examined. References and CRB checks were in place. This was followed up with a formal induction process LDAF (Learning Disabilities Award Framework). There was evidence that all these staff had received formal supervision. In the AQAA the manager stated the areas thety do well at are ‘Staffing levels are based on the Residential Forum Guidance. The service rarely has vacant posts, and we have increased our staff bank team and are able to cover annual leave/sickness with consistent and trained staff.’ In the future they plan to ‘Involve people living in the service in recruitment process.’ One relative wrote “We are satisfied with the overall competence of full time staff support workers…Relief staff and agency workers may need direction”. Middlefield Manor Residential Home DS0000024447.V335273.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. Residents, and their representatives can expect that the home is appropriately managed. The health, safety and welfare of people using this service are being promoted, but matters around health and safety could be further improved. EVIDENCE: The manager of the home has become appropriately qualified and holds NVQ 4 in Care as well as the Care Managers Award. One relative has written “Paul Steward is very good and very caring…In my opinion he is the best manager Middlefield Manor has ever had”. Another relative wrote “Middlefield Manor provides a good service and a safe and happy environment. I and my family much appreciate the efforts of the staff”. Another relative wrote “our relative has lived in several care homes since he Middlefield Manor Residential Home DS0000024447.V335273.R01.S.doc Version 5.2 Page 23 was 17 years old and I believe Middlefield Manor is one of the best”. Two other relatives thought that communication from the manager could be improved. The manager completed the AQAA and returned the information promptly. The home is subject to regular visits by their organisation and a monthly report is written that complies with Regulation 26. The home completed it’s own internal monthly auditing to monitor practices. In the AQAA the manager feels the service could do better by: ‘We have a new pictorial format to help people living in the service express their choices and ideas for life. This is headed MY CHOICES AND IDEAS FOR MY LIFE. People will be supported by the Advocate to fill this document in so it can be used in peoplee planning meetings and circle meetings in order for documentation in their Person Centred Plans.’ The home already have an independent advocate working alongside residents and staff. In regard to health and safety reference has already been made in the staffing section to the appropriate training staff receive and comment has been made on the need for hand washing in the laundry and windows unrestricted in the environment section. The fire service has visited this service in June 2007 and the manager confirmed all action has been taken and that the home has a completed fire risk assessment in place. Middlefield Manor Residential Home DS0000024447.V335273.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 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 2 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 3 3 3 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.V335273.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 YA30 Regulation 13 (3) Requirement Timescale for action 21/09/07 2. YA24 13 (4)(a) Staff must have access to a wash hand basin and be able to wash their hands before leaving the laundry to prevent the spread of any potential infection around the home. All parts of the home that 21/09/07 residents have access to must be as safe as possible. Any window accessible to people (2 meters above ground level) must have a restricted opening to prevent falls. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA9 Good Practice Recommendations Risk assessments should be based upon individual circumstances and linked to care plans. Middlefield Manor Residential Home DS0000024447.V335273.R01.S.doc Version 5.2 Page 26 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. Extracts may not be used or reproduced without the express permission of CSCI Middlefield Manor Residential Home DS0000024447.V335273.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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