Inspection on 21/02/06 for Milton Keynes Community Care Services

This inspection was carried out on 21st February 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 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Milton Keynes Community Care... 24/04/08

Milton Keynes Community Care... 25/04/06

Milton Keynes Community Care... 05/07/05

Milton Keynes Community Care... 14/02/05

Milton Keynes Community Care... 07/07/04

Milton Keynes Community Care... 27/01/04

Milton Keynes Community Care... 20/10/03

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

CARE HOME ADULTS 18-65 Milton Keynes Community Care Services 1 Fletchers Mews Neath Hill Milton Keynes Bucks MK14 6HW Lead Inspector Mrs Maureen Richards Unannounced Inspection 21st February 2006 10:00 Milton Keynes Community Care Services DS0000015066.V282937.R02.S.doc Version 5.1 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 Milton Keynes Community Care Services DS0000015066.V282937.R02.S.doc Version 5.1 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. Milton Keynes Community Care Services DS0000015066.V282937.R02.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Milton Keynes Community Care Services Address 1 Fletchers Mews Neath Hill Milton Keynes Bucks MK14 6HW 01908 660364 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) SCOPE Linda Jillian Ambrose Care Home 18 Category(ies) of Physical disability (18), Physical disability over registration, with number 65 years of age (2) of places Milton Keynes Community Care Services DS0000015066.V282937.R02.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. This home is registered for 18 people with a physical disability with up to two people over the age of sixty-five years. Linda Ambrose That the registered manager, Linda Ambrose, is only granted to manage the registered part of the scheme. 5th July 2005 Date of last inspection Brief Description of the Service: Milton Keynes Community Care Service is registered as a care home. The service consists of a staff base at the resource centre and individual properties situated around the Neath Hill estate. There are currently fifteen properties accommodating eighteen service users registered at this service. Staff provide personal care and support to service users in their own flats by prior arrangement or on request, via a twenty - four hour intercom system. The properties are owned by Milton Keynes Council. Scope, the organisation, are tenants of Milton Keynes Council. The properties are located within a mile radius of the staff base. The properties are accessible to Milton Keynes centre and local shops via the red route, which is specifically adapted for wheelchair users. Milton Keynes Community Care Services DS0000015066.V282937.R02.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on the 21st February 2006. It started at 10.00 am and finished at 16.00 hrs. Two inspectors facilitated the inspection. The majority of the key standards were inspected at the previous announced inspection. The purpose of this inspection was to follow up on the progress made in meeting the requirements from the previous inspection and to establish if progress noted at that inspection had been maintained. The inspection consisted of visits to six individual properties, private discussions with three service users, discussion with the registered manager and examining records. Some service users commented “that things were running smoothly on the scheme and felt that the service was being well managed”. This was a positive inspection with the majority of requirements from the last inspection met. The manager and staff team have worked hard and together to meet and improve the standard of care and to provide a more pleasant environment for service users. They should be congratulated for their hard work and commitment to the development and improvements noted in this service to motivate them to maintain and further develop this service. What the service does well: What has improved since the last inspection? Service user plans continue to be developed. Individual risk assessments are in place to ensure a consistent approach in managing behaviours. An individual record has been set up to record aggressive behaviour and staff responses to situations. Service user files kept at the office are kept secure. Systems are in place to ensure that service users food is fresh, stored appropriately and cooked to a safe temperature level. Properties continue to be updated and decorated and the doorways in one property have been widened to allow the service user easier access in her home. Milton Keynes Community Care Services DS0000015066.V282937.R02.S.doc Version 5.1 Page 6 Staff files are well organised and contain the required information to indicate safe recruitment practices. Staff have up to date mandatory training. Safe working practice risk assessments have been put in place. Complaint and accident report records are being fully completed to indicate action taken and any event, which affects the well being of a service user, is being reported to the Commission. Service user risk assessments have been put in place to address any risks posed to service users who have access to latex gloves. The manager has worked closely with the fire authority in addressing requirements relating to the fire inspection and the Fire Authority has agreed to part fund a water sprinkler system for each property as part of a new government initiative. 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. Milton Keynes Community Care Services DS0000015066.V282937.R02.S.doc Version 5.1 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 Milton Keynes Community Care Services DS0000015066.V282937.R02.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: None of the above standards were assessed at this inspection. Standard 2 the key standard has not been assessed over the two inspections, as there have been no new admissions to this service during this time. Milton Keynes Community Care Services DS0000015066.V282937.R02.S.doc Version 5.1 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6&9 Service user plans are detailed and specific in plan of care, which ensures that service users needs are met in a safe and consistent way. Risk assessments are not reviewed and updated as required which potentially could put staff and service users at risk. EVIDENCE: Five service user plans were viewed at his inspection. Service users have a care plan in each of their properties and a duplicate copy of this care plan is kept at the staff office. The plans included a personal details information sheet. Each care plan included a personal care and physical support needs plan. These were detailed and specific as to the care required in supporting individuals during each call. Care plans included the date of implementation and written evidence of being reviewed. Some care plans did not indicate evidence of service user involvement in their development and review. A requirement was made at the previous announced inspection that service user plans must be further developed to ensure that all required information is completed and to ensure that information within the plan does not contradict Milton Keynes Community Care Services DS0000015066.V282937.R02.S.doc Version 5.1 Page 10 other guidance. This was found to be complied with in the sample of care plans seen. A recommendation was made at the previous inspection that report writing training should be provided for staff. The manager confirmed that formal training has not taken place and she addresses issues with staff as they occur. Service user plans include individual and generic risk assessments and separate moving and handling assessments. Some generic assessments and moving and handling risk assessments were overdue for review. Requirements were made at the previous announced inspection that moving and handling risk assessments must be kept updated to reflect actual practice. This has not been fully complied with. A requirement was made at the previous announced inspection that the service users risk assessments must be updated to specifically outline the behaviours that leads to a risk and clear guidelines must be put in place and followed to manage identified risk. This has been complied with and reinforced to staff at staff meetings. A requirement was made at the previous announced inspection that the manager must ensure that bad practice and failure to follow guidelines and procedures by staff is dealt with appropriately. Records seen at this inspection did not indicate any such occurrences. However this must be continuously monitored and addressed as and if situations arise. A recommendation was made at the previous announced inspection that the specific and generic risk assessments should be filed separately within service users files and made more accessible. This has been put in place. A recommendation was made at the previous announced inspection that the manager should consider the introduction of ABC charts for recording outbursts of aggression by service users. This has been included in service users files as required. Standard 10 was not assessed at this inspection. A requirement was made at the previous announced inspection that service users files kept at the staff office must be kept secure. This has been complied with. Milton Keynes Community Care Services DS0000015066.V282937.R02.S.doc Version 5.1 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 17 Service users are involved in shopping for and choosing their meals, which are cooked by staff. The meals provided are fresh, stored appropriately and safely to ensure the health and well being of service users. EVIDENCE: Staff support service users with shopping, preparing and cooking meals as required. Time is included within individual calls to support service users with three meals a day. The level of support required by individuals with their meals is outlined in the care plan. Service users choose what they want to eat and staff support service users as required. A record is maintained of meals eaten and of the temperature of the food. The records indicate that the food temperature records are within the required safe levels. As some service users do their own shopping, some food records indicate a high intake of processed food. A recommendation was made at the previous announced inspection that nutrition training should be accessed for staff to ensure that staff can support service users to eat a balanced diet. The manager confirmed that this has not been accessed as the service would Milton Keynes Community Care Services DS0000015066.V282937.R02.S.doc Version 5.1 Page 12 access a dietician for individuals if felt required and are unable to prevent some service users from buying and choosing their own meals. Fridges, freezers and food cupboards seen were found to be well organised with all food in date and labels on food to indicate when it was first opened. Staff continue to work with service users in ensuring that the food supplies are fresh and in date. This is now being consistently monitored and maintained. One service user expressed concern that staff wore gloves whilst assisting him to eat his meal and when eating a sandwich this results in the glove being put in his mouth. He found this to be degrading and unnecessary. Discussed with the manager who advised that this was health and safety guidelines and that the service user could choose to have staff wear gloves or use a fork to put the sandwich in his mouth. The manager must discuss this practice further with health and safety representatives and if consider if there are any more suitable aids available to assist the service user with his sandwich. Milton Keynes Community Care Services DS0000015066.V282937.R02.S.doc Version 5.1 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: None of the above standards were assessed at this inspection. The key standards were inspected and met at the previous announced inspection. Under standard 20 it was noted that there were some gaps in the medication administration records and codes were not being used to indicate if medication was omitted and why. This must be addressed and monitored. Milton Keynes Community Care Services DS0000015066.V282937.R02.S.doc Version 5.1 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: Standard 22 was not fully assessed at this inspection. Standard 22 was assessed at the previous announced inspection. The complaints log indicates that there have been two formal complaints since the previous announced inspection, which were dealt with appropriately. During the inspection one service users made the inspectors aware of an incident between him and a staff member the previous week, which resulted in the staff member terminating the call. The manager met with the service user to address the incident and to defuse the situation. This was not logged as a complaint from the service user against the staff member, nor as an incident and there was no reference to it within the service users file in the daily recording sheet for that day. The manager confirmed that the team leader had met with the staff member following the incident but records were not available to confirm the outcome of this. The manager must ensure that accurate records of incidents and complaints are maintained and that she has access to all staff supervision records to ensure such incidents are followed up and addressed with staff. Standard 23 was not assessed at this inspection. Standard 23 was assessed at the previous announced inspection. A requirement was made at the previous announced inspection that challenging behaviour training must be provided for staff to ensure that staff manage challenging behaviour situations safely. This has not been complied with. The manager does not feel it is necessary as the service has low incidences of aggression. In depth discussions have taken place at team meetings to ensure that staff are clear of how to handle potential aggressive situations and individual risk assessments are in place to Milton Keynes Community Care Services DS0000015066.V282937.R02.S.doc Version 5.1 Page 15 support this. The introduction of a monitoring and recording of aggressive behaviour chart indicates that staff are now following the risk assessment. Milton Keynes Community Care Services DS0000015066.V282937.R02.S.doc Version 5.1 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 30 The level of cleanliness in service users property continues to be maintained and monitored which promotes the health, safety and well being of service users. EVIDENCE: Standard 24 was not fully assessed, as all of the properties were not visited at this inspection. All of the properties were visited at the announced inspection. Six properties were visited at this inspection. Five of the properties visited have been redecorated internally. One of the properties seen was scheduled to be decorated and new flooring put down. Some service users have got new furniture and all of the properties seen have had had new lighting fitted in the sitting area. Some of the properties seen would benefit from an up to date kitchen. The manager confirmed that a programme of redecoration and updating of the properties is in place in conjunction with Milton Keynes Council to bring all of the properties up to the required standard. None of the properties have been decorated externally. An enforcement notice was served in March 2004 for doorways to be widened to allow service users easy access to all areas of their home. The organisation had identified one service user whom they had assessed as requiring this. An occupational therapy assessment had been carried out and the sitting room Milton Keynes Community Care Services DS0000015066.V282937.R02.S.doc Version 5.1 Page 17 and bedroom door in one service users property have recently being widened. This property is now scheduled to be decorated and new flooring put in place. This enforcement notice has been complied with. The service continues to use agency-cleaning staff. The majority of properties have four hours cleaning per week. A cleaning schedule is in place for each property, which is completed by the cleaning staff and checked and signed off by a senior member of the staff team. The standard of cleanliness in all of the properties seen has significantly improved and is being maintained since the previous announced inspection. The service has health and safety polices in place, which were not viewed at this inspection. Milton Keynes Community Care Services DS0000015066.V282937.R02.S.doc Version 5.1 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35 Specialist training is not made available to staff however NVQ training is promoted to ensure that service users are supported by qualified staff. Safe recruitment practices are in place which safeguard service users. Staff training files seen indicate that those staff have the majority of the required mandatory training which safeguards service users. EVIDENCE: Staff are accessible to service users via an intercom system. No issues were raised by service users about staff’s listening and communication skills. The rota indicates some sickness but staff are generally reliable and honest. The improvements noted within the service indicate staff commitment to the development of this service. The sample of training records seen indicate that staff do not have training in the specific conditions of service users, communications skills training or in dealing with anticipated behaviours and physical and verbal aggression. Some staff have had disability equality training. During induction staff work alongside experienced staff in getting to know service users and in developing an understanding of how they support individuals. The service has no staff under 18. The manager has been proactive in promoting NVQ’s and the manager confirmed that twenty of the twenty-six care staff are working towards or have achieved an NVQ. Milton Keynes Community Care Services DS0000015066.V282937.R02.S.doc Version 5.1 Page 19 Standard 33 was not assessed at this inspection. This standard was assessed and met at the previous announced inspection. A recommendation was made at that inspection that the manager should be included on the staff rota and the rota should outline when she has worked a shift in providing personal care. The rota was seen which indicates shift and hours worked by the manager. Staff meeting minutes indicate that staff meetings are held monthly. The minutes are well recorded and a range of issues is discussed. Three staff files were viewed at this inspection. The staff files seen included a checklist to confirm what documentation had been requested and received, a signed confidentiality statement, an application form, interview assessment, health declaration, two references and a letter to confirm CRB clearance and CRB number. Files contained a copy of driving licence, birth certificate and passport. One of the three files seen contained an up to date photograph of the staff member. The service uses agency cleaners and occasional agency care staff. The manager has obtained copies of references, confirmation of CRB clearance and up to date training records for individual agency staff. The agency does not confirm that individuals have valid work permits where required. The manager should obtain confirmation of this. A requirement was made at the previous announced inspection that the manager should ensure that schedule 2 information is obtained for all staff including agency staff working within the service. The staff files seen confirm this has been complied with. New staff work alongside experienced staff in getting to know service users needs and personal care calls. The service has a folder which includes the key policies and procedures to be covered during induction. Staff training files include confirmation of an induction day for new staff and an induction checklist is used to confirm in house inductions. Staff training is recorded on individual files. The manager had developed a matrix of all staff training but found it difficult to keep it up to date. Eight staff training records were seen which indicate that the majority of those staff have the required mandatory training. One staff member is overdue for fire safety training. The manager was aware of this and has already identified for this individual to attend the next planned fire safety training. The training records did not confirm that all staff have safe handling in medication training and new staff have not had adult protection training. Adult protection training is facilitated in house and this training is scheduled to take place. A requirement was made at the previous announced inspection that the manager must ensure that all staff have up to date mandatory training. This has been complied with and requires continuing monitoring and updating. Milton Keynes Community Care Services DS0000015066.V282937.R02.S.doc Version 5.1 Page 20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37 The service is being well managed and effectively monitored which has resulted in an improved standard of care and accommodation for service users. EVIDENCE: The manager has been in post since September 2004. She was registered by the Commission in 2005 as the registered manager of the registered part of the scheme only. The manager has achieved an NVQ 4 award. The manager has been proactive in meeting the majority of the nineteen requirements from the previous announced inspection and in developing the staff to meet and improve standards of care. The manager and staff team have worked extremely hard in developing this service to benefit service users. Some service users commented “that things were running smoothly and that the service was being well managed”. Standard 39 was not assessed at this inspection. This standard was assessed at the previous announced inspection and a requirement was made that the organisation must ensure that an annual quality audit takes place, which is carried out by someone independent of the service and seeks feedback from Milton Keynes Community Care Services DS0000015066.V282937.R02.S.doc Version 5.1 Page 21 staff, service users, families and other relevant professionals involved with the service. The manager advised that this was something the organisation was working on and therefore this requirement has not been complied with. The manager has set up a standard setting committee which includes four staff and five service users which has met once and agreed the aims and objectives of the group. Records indicate that monthly service user meeting take place and last month’s minutes indicate an increase in service users attendance at that meeting. A requirement was made at the previous announced inspection that the organisation must ensure that monthly regulation 26 visits take place and a copy of the report on the visit must be sent to the Commission following the visit. Since the previous inspection the Commission has had to request those reports although recently the registered manager confirmed that she arranges for a copy to be sent. This must be maintained. Standard 42 was not assessed at this inspection. Standard 42 was assessed at the previous announced inspection. Requirements were made that hazardous cleaning materials must be kept secure at all times. Some hazardous cleaning materials were visible in one service user’s property but the manager confirmed that that service user would be unable to access it due to their disability. A risk assessment should be put in place to support that. A requirement was made that the manager must identify what activities staff are involved in, in the course of their work and a range of risk assessments must be put in place to reduce the risk posed by those activities. This has been complied with. A requirement was made that the manager must ensure that all accident reports are fully completed and poor practice and moving and handling issues must be addressed with the staff concerned. Accident records seen indicate that this has been complied with and must continue to be monitored and maintained. A requirement was made that the manager must seek medical advice following injury to a service user. The accident reports seen indicate this is now being complied with although the regulation 37 reports sent to the Commission are not fully completed in line with the accident form. The manger agreed for a copy of the accident report to be sent with the regulation 37 reports to confirm the action taken. A requirement was made that the manager must ensure that incidents, which affect the well being of service users are reported to the Commission. This is been complied with. A requirement was made that the organisation must ensure that requirements from the fire inspection are acted on in relation to the enforcement notice served in March 2004. The manager has liaised with the fire authority on this and the fire authority has confirmed in writing that they were satisfied that the items contained in their report of the 3rd February 2003 have been complied with. Milton Keynes Community Care Services DS0000015066.V282937.R02.S.doc Version 5.1 Page 22 A requirement was made at the last inspection that internal fire doors in service users properties must not be wedged open. Where service users require doors to be kept open to allow access to all areas of their home then approved self-closing devices, as approved by the fire authority, must be fitted. The letter from the fire authority outlines that overhead door closures which incorporate a hold open mechanism that can be easily manually closed are considered acceptable as opposed to automatic release devices which could result in service users being trapped in their bedrooms. Staff must also ensure that all fire doors are closed at night. No fire door in the properties seen was observed to be wedged open during this inspection. The fire authority has agreed to part fund water sprinklers for each property as part of a new Government initiative. A requirement was made at the previous announced inspection that a risk assessment must be carried out for each service user to establish their risks of being able to access the latex gloves and causing injury to themselves. Service user plans include a risk assessment to address this. It was noted at this inspection that service user plans included records of water, fridge and freezer temperatures checks, which were within safe levels and action being taken to address out of range temperatures. Milton Keynes Community Care Services DS0000015066.V282937.R02.S.doc Version 5.1 Page 23 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 X 2 X 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 X ENVIRONMENT Standard No Score 24 X 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 X X 2 X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X X X 3 X 2 X X X X Milton Keynes Community Care Services DS0000015066.V282937.R02.S.doc Version 5.1 Page 24 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 YA9 Regulation 13 Requirement Risk assessments including moving and handling risk assessments must be kept updated and reviewed to reflect actual practice. (Previous timescale of 31/08/05 not fully complied with.) The manager must discuss the practice of staff wearing gloves to assist a service user with a sandwich with the health and safety representatives and if this is policy consider if there are any more suitable aids available to assist the service user with his sandwich, which continue to promote his dignity. The manager must ensure that all medication administered is signed for and codes are used to explain any gaps in administration. The manager must ensure that records are maintained of all complaints or incidents as they occur and staff supervision files should be accessible to the manager to confirm that staff’s response to a situation has been addressed. DS0000015066.V282937.R02.S.doc Timescale for action 21/03/06 2 YA17 12 31/03/06 3 YA20 13 21/03/06 4 YA22 17 & 22 31/03/06 Milton Keynes Community Care Services Version 5.1 Page 25 5 YA39 24 The organisation must ensure that an annual quality audit takes place, which is carried out by someone independent of the service and seeks feedback from staff, service users, families and other relevant professionals involved with the service. (Previous timescale of 31/06/04 & 30/12/05 not met) 30/04/06 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 34 42 Good Practice Recommendations The manager should check with the agencies that individual staff have up to date work permits and visa’s where required. Risk assessments should be put in place to confirm that individual service users are unable to access hazardous chemicals seen in one service users property. Milton Keynes Community Care Services DS0000015066.V282937.R02.S.doc Version 5.1 Page 26 Commission for Social Care Inspection Aylesbury Area Office Cambridge House 8 Bell Business Park Smeaton Close Aylesbury HP19 8JR National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Milton Keynes Community Care Services DS0000015066.V282937.R02.S.doc Version 5.1 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!