Inspection on 28/08/07 for Nottingham Neurodisability Services Aspley

This inspection was carried out on 28th August 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 12 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Nottingham Neurodisability... 07/07/08

Nottingham Neurodisability... 19/12/07

Nottingham Neurodisability... 29/08/06

Nottingham Neurodisability... 06/12/05

Nottingham Neurodisability... 23/05/05

Nottingham Neurodisability... 13/07/04

Nottingham Neurodisability... 10/06/04

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

CARE HOME ADULTS 18-65 Nottingham Neurodisability Services Aspley Robins Wood Road Aspley Nottingham NG8 3LD Lead Inspector Steve Keeling Key Unannounced Inspection 28th August 2007 09:00 Nottingham Neurodisability Services Aspley DS0000059536.V349246.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 Nottingham Neurodisability Services Aspley DS0000059536.V349246.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. Nottingham Neurodisability Services Aspley DS0000059536.V349246.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Nottingham Neurodisability Services Aspley Address Robins Wood Road Aspley Nottingham NG8 3LD 0115 942 5153 0115 942 5154 aspley@fshc.co.uk/ colette.manning@ffhc.co.uk 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) Four Seasons Homes (Ilkeston) Ltd Post Vacant Care Home 32 Category(ies) of Physical disability (32) registration, with number of places Nottingham Neurodisability Services Aspley DS0000059536.V349246.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 29th August 2006 Brief Description of the Service: Aspley Neuro-disability Unit is a purpose built unit situated in the inner city area of Nottingham. The home is within access to local shops, library, health centre, churches and a pub. A variety of communal areas are available which includes two lounges and a dining area. Resident’s bedrooms are situated on the ground floor and the first floor and a passenger lift facilitates access to the first floor. All bedrooms are of single occupancy and fitted with an en-suite facility. The fees currently charged at the home are £550 to £650 per week. Additional costs for hairdressing, newspapers, toiletries, holidays and podiatry intervention are charged at current retails prices. Nottingham Neurodisability Services Aspley DS0000059536.V349246.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for residents and their views on the service provided. This process considers the provider’s capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provision that need further development. One inspector conducted the unannounced visit. The main method of inspection used was called ‘case tracking’ which involved selecting two residents and looking at the quality of the care they receive by speaking to them, observation, reading their records and asking staff about their needs. The deputy manager and one member of staff were spoken with as part of this visit. Documents were read as part of this visit and medication management was inspected to form an opinion about the health and safety of residents at the home. A partial tour of the building was undertaken which included a sample of resident’s bedrooms, to make sure that the environment is safe and homely. A review of all the information we have received about the home since the last inspection was considered in planning this visit and this helped decide what areas were looked at. A range of additional information was used to determine the outcome of this visit, which includes information provided by the registered provider within an Annual Quality Assurance Assessment (AQAA). As part of the inspection process, the conditions of registration were reviewed with acting manager. Details relating to the registered provider were incorrect and the centralised Registration Team at CSCI will follow up the issuing of new certificate. What the service does well: Potential residents or their representatives are provided with a Service user Guide that contains information relating to the service. Effective pre admittance assessments are performed prior to people moving into the home to identify the needs of the residents. Residents are provided with the opportunity to take part in a variety of activities both within the home and in the community. Residents can maintain contact with their family and friends as they wish. Nottingham Neurodisability Services Aspley DS0000059536.V349246.R01.S.doc Version 5.2 Page 6 An effective consultation process is provided for the residents, which enable them to make choices about their own lives. Staff are aware of their roles and responsibilities in relation to Safeguarding Adults, which protects residents. Resident’s needs are met by the number of staff employed at the home and staff have received training. What has improved since the last inspection? What they could do better: The Service users guide should contain details of the fees charged at the home to enable residents to be fully aware of the cost of the services provided before they move in. The meeting of resident’s needs should be better addressed through the development of by effective care planning procedures. Routines at the home could be more flexible to promote the residents independent decisions. Residents should be provided with meals that they enjoy ensuring they look forward to mealtimes and their lifestyle is enhanced. Medication management could be improved to ensure the safety of residents. Recruitment practices and the management of complaints should be improved to ensure the safety and protection of residents and increase confidence in the management of the home. Quality auditing systems should be improved to ensure that the service improves based on the needs identified. 50 of care staff should be educated to National Vocational Qualification (NVQ) level two and above to enable staff to meet resident’s care and support needs. The acting manager must make an application to register with the CSCI to avoid prosecution for managing a care home without registration. Nottingham Neurodisability Services Aspley DS0000059536.V349246.R01.S.doc Version 5.2 Page 7 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. Nottingham Neurodisability Services Aspley DS0000059536.V349246.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Nottingham Neurodisability Services Aspley DS0000059536.V349246.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Service Users Guide does not contain details of the fees charged at the home, which could result in the residents not being able to determine the suitability of the service in meeting their needs. People have effective assessments performed prior to moving into the home to ensure their needs are identified. EVIDENCE: We asked a recently admitted resident if he received enough information about the service so he could decide if it was the right place for him. The resident confirmed that he was provided with a Services User Guide and said that he found the information within the guide to be informative and useful. The Service Users Guide contains comprehensive information relating to the service provision at the home but does not specify the fees charged at the home which could compromise the residents or their representatives ability to determine the suitability of the service in meeting their needs. Nottingham Neurodisability Services Aspley DS0000059536.V349246.R01.S.doc Version 5.2 Page 10 Records showed that, suitably qualified staff perform pre admittance assessments to determine the needs of the residents and additional professional assessments are also used when available. Nottingham Neurodisability Services Aspley DS0000059536.V349246.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9, 10. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Residents’ health and personal care needs are not effectively addressed through the care planning procedures, which means they are at risk of receiving inappropriate support. Resident’s independence is inconsistently promoted, leaving some people unable to actively make decisions about their care and support needs. EVIDENCE: Information with the Annual Quality Assurance Assessment said that careplanning documentation has improved over the last 12 months. Care plans seen were of variable quality. One resident’s care planning documentation, formulated by a student nurse, provided detailed information to inform staff on how the needs of the resident can be met. Nottingham Neurodisability Services Aspley DS0000059536.V349246.R01.S.doc Version 5.2 Page 12 The second case tracked care plans did not address all the identified needs of the resident. No risk assessments or care plans had been developed in relation to pressure sore prevention, continence promotion and specialist drug therapies, although the issues had been identified within the pre admission assessment. Care plans that were in place in relation to food allergies, assistance with hygiene needs and moving and handling were not in sufficient detail to inform staff. Residents gave us conflicting information in relation to being able to make independent decisions. One resident said that staff respected his wishes at all times and has full control over his life. The resident said that his independence is promoted and he is encouraged to take risks as part of and independent lifestyle. A second resident had concerns that the routines at the home are not flexible enough. They said that their ability to make independent decisions and choices is compromised, as staff do not respect her choice in relation to when she is woken up and assisted out of bed. Residents expressed concerns in relation to the maintenance of confidential information. Residents said that some staff openly discuss residents personal details and felt that the practice compromises their respect and dignity and the practice is unacceptable. Records showed, and a resident confirmed that residents meetings are performed on a regular basis to ensure residents have the opportunity to discuss developments within the home. Nottingham Neurodisability Services Aspley DS0000059536.V349246.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16, 17. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents are provided with the opportunity to take part in a variety of activities both within the home and in the community and are supported to maintain contact with their family and friends, however, the current meal provision and atmosphere compromises their enjoyment of the dining experience. EVIDENCE: Social activity co-ordinators are employed at the home to provide a varied and stimulating social activities programme and residents said they are satisfied with the recreation provided. Nottingham Neurodisability Services Aspley DS0000059536.V349246.R01.S.doc Version 5.2 Page 14 A fully equipped activities room is available for residents on the first floor of the building. Records showed and residents confirmed that activities performed within the home include board games, arts and crafts, cookery sessions, quizzes, crosswords and newspaper readings, to ensure residents are kept up to date on current events in the media. A large wide screen television is available in the residents lounge together with a DVD player so residents can enjoy films and television programmes. A wheelchair accessible minibus is available and residents confirmed that they are able to access trips into the local community. The deputy manager said that an open door policy is operated in relation to visits and residents confirmed that they could maintain appropriate relationships within family and friends as they wish. Residents spoken with were dissatisfied with the quality of food provided and said that they did not look forward to meal times. Comments made by residents included “I am living on sandwiches as the food is so poor. A choice is made available but I do not like what is being served”. A resident said that there is little variation for puddings at lunchtime as it is mostly cake or yogurt. Residents were particularly concerned about the attitude of the staff at mealtimes. Residents said that staff shout from one end of the dining room to the other to determine the residents meal and drink preferences, which residents felt compromised their enjoyment of the dining experience. Nottingham Neurodisability Services Aspley DS0000059536.V349246.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Residents do not receive the personal support in a way they prefer and require and residents physical and emotional needs are not always being met. Medication management procedures do not promote the safety of residents. EVIDENCE: Records showed that residents have access to health care services both within the home and in the local community such as a General Practitioners, Dentists, Social Workers and Opticians. Residents also confirmed that staff respond appropriately to their requests to see their GP if they feel unwell. A range of mobility aids is available throughout the home to promote the health, wellbeing and independence of the residents with restricted mobility. The resident’s choice is compromised in relation to the bathing facilities at the home as a specialist bath had been decommissioned and had not been available for the past four weeks. An alternative bath had been supplied but Nottingham Neurodisability Services Aspley DS0000059536.V349246.R01.S.doc Version 5.2 Page 16 the deputy manager confirmed that it was not in use as she was awaiting a safety certificate from the manufacturer. Residents were particularly concerned that some staff used inappropriate language, which they found offensive. A resident said, “The swearing is disgusting by some the staff”. A resident said that she feels that the respect and dignity of residents is not promoted and said “It’s like us and them, they only respect my wishes when it suits them and I do not receive the support I require from the staff”. Residents were also concerned that on several occasions night staff were observed to be asleep for long periods of time whilst on night duty which they felt was unacceptable and compromised their safety. We observed medication being administered to a resident. The qualified nurse did not follow the correct procedures as she signed the residents Medication Administration Record (MAR) prior to witnessing the residents taking the medication. Medication, which requires refrigeration, was stored within a secure fridge in the medication room. The temperature within the medication fridge is recorded on a daily basis but the temperature was significantly outside the acceptable parameters of 2-8 degrees centigrade. The qualified nurses spoken with were unable to stipulate the correct temperature, which the medication fridge should be maintained at. Nottingham Neurodisability Services Aspley DS0000059536.V349246.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The management of concerns and complaints is ineffective, as residents do not feel valued or listened to. Residents do not feel protected and able to live a life free from abuse verbally or financially. EVIDENCE: Since the last key inspection there have been three complaints relating to the service provision at the home. One of which is being investigated by the Police, one being looked at by Social Services and the third being investigated by registered provider. Records showed that investigations are ongoing and CSCI is awaiting the outcome of the complaints. A complaints procedure is displayed in the foyer of the home and a complaints procedure is provided within the Service User Guide. The complaints procedure states that should residents, relatives or visitors wish to make a complaint it will be recorded in a complaints register and an investigating officer will be assigned to conduct a full investigation. A resident spoken with said that he had made a complaint, but had not received a satisfactory response. The Deputy manager recalled the complaint being made but was not able to provide evidence that the complaint had been acknowledged or the resident had received a written response. The deputy manager confirmed that the policy relating to the management of complaints had not been followed. Nottingham Neurodisability Services Aspley DS0000059536.V349246.R01.S.doc Version 5.2 Page 18 Other residents expressed concerns in relation to the management of complaints, saying that they has raised issues but had felt intimidated by some staff. “Things have not been easy”, staff are reported to have asked residents “who put you up to this, you would not have done it off your own back”. As mentioned earlier in the report (YA10) residents expressed concerns in relation to staff not maintaining residents confidentiality and said that residents personal details are openly discussed by staff”, which makes them feel uncomfortable in making a complaint about the service provision. Records showed that staff have received training in Safeguarding Adults. A member of staff spoken with demonstrated a good understanding of Safeguarding Adults procedures. The member of staff said that initially she would ensure the safety of the resident in question, report the matter to the manager or the person in charge and follow the policies and procedures in relation to Safeguarding Adults. Computerised documentation relating to the management of residents money evidenced that some resident’s money is currently pooled in a joint account (interest free) in which individual names and corresponding monies could be evidenced. Nottingham Neurodisability Services Aspley DS0000059536.V349246.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a homely, comfortable and safe environment, which is clean and hygienic. Specialist equipment is available to promote residents independence. EVIDENCE: The homes internal environment, including the dining rooms and the lounge areas, are clean, fresh and homely throughout. All areas within the home are accessible to residents in wheelchairs and residents said they are satisfied with the overall standard of hygiene at the home. Nottingham Neurodisability Services Aspley DS0000059536.V349246.R01.S.doc Version 5.2 Page 20 Resident’s bedrooms are well maintained, clean and fresh. Window restrictors are evident throughout the home to promote the safety of residents. Residents are encouraged to personalise their bedrooms with televisions, radios, posters and family pictures to further promote a homely environment. Equipment to promote the residents independence is available throughout the home, such as adjustable height beds and hoists. As mentioned earlier in the report the specialist bath had been decommissioned and an alternative bath has been purchased. A secure garden area is available for residents to use in the summer months. The garden area is accessible to residents with impaired mobility and has a barbeque area, which the residents can use if they wish. The home employs a maintenance man to carry out any minor repairs and there is a maintenance book to record any repairs that need doing. Residents expressed concerns that lockable facilities are not always available in their bedrooms to ensure items of value are secure. The maintenance man said that the locks to fit the bedside draws are no longer available as the draws are so old; he said that it would be preferable if new furniture were made available which incorporated a lockable facility. Nottingham Neurodisability Services Aspley DS0000059536.V349246.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 34, 35, 36. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The percentage of suitably qualified and competent staff is half the National Minimum Standard, recruitment policies have not been followed and staff supervision is inconsistent which compromises the effectiveness of a staff team to promote the health and wellbeing of residents. EVIDENCE: Staff said and records confirmed that an induction process is performed for all new staff on commencement of employment and the induction process has been recently amended to include the “Skills for Care” principles. Information provided within the AQAA evidences that the service has only achieves 25 of the required 50 of staff trained to, or working towards a National Vocational Qualification (NVQ) Level Two and above. Nottingham Neurodisability Services Aspley DS0000059536.V349246.R01.S.doc Version 5.2 Page 22 Records showed and staff confirmed that additional training is provided in relation to safeguarding adults, first aid, nutrition, health and safety, moving and handling, infection control, falls and continence promotion. Records showed and the deputy manager confirmed that some staff have not received formal supervision sessions to ensure they are effectively supported and developed to perform their roles within the home. The member of staff had received an annual appraisal but the appraisal documentation had not been filled out in full, as the sections in the appraisal documentation relating to the “overall performance rating” was blank. Records showed that staff have been allowed to commence employment before two satisfactory references were available although Protection of Vulnerable Adult (POVA) checks and Criminal Record Bureau (CRB) checks had been obtained. Nottingham Neurodisability Services Aspley DS0000059536.V349246.R01.S.doc Version 5.2 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The acting manager is in breach of the Care Standards Act and not accountable as not registered with CSCI. Documentation is disorganised and not readily available for inspection. Quality auditing systems are in place but are not effective in identifying poor practice which results in the home not run in the best interests of the residents living there. EVIDENCE: Staff spoken with felt supported and valued by the acting manager saying that the she promotes a good team spirit. Residents confirmed that they are provided with the opportunity to contribute to any developments within the home as “residents meetings” are performed Nottingham Neurodisability Services Aspley DS0000059536.V349246.R01.S.doc Version 5.2 Page 24 on a monthly basis. Residents said that the meetings are of value and they feel included in any developments within the home. Information provided within the AQAA shows that policies and procedures are updated on an annual basis and staff confirmed that they have access to the policies and procedures at all times for reference and guidance. Although a quality-auditing tool is available, it is not utilised effectively. The deputy manager confirmed that the current quality auditing process is “not constructive” in identifying poor practice in relation to medication management, care planning and complaints documentation. Documentation was disorganised and was not easily accessible, which significantly impeded the inspection process. The deputy manager said that an administration officer is not currently employed at the home and agreed that the management of documentation could be improved. The acting manager has previously made an application to CSCI to be the registered manager. The application was returned with a request for additional information. Our registration team at CSCI confirmed that to date the additional information has not been provided thus delaying the manager’s application. Unless an application to register is submitted without delay, the acting manager continues to be in breach of the Care Standards Act and is liable for prosecution. As mentioned earlier in the report residents spoken with expressed significant concerns in relation to quality of care afforded to them. Residents said that the attitudes of some staff in relation to the maintenance of resident’s confidentiality, the use of inappropriate language and the management of complaints needs to improve to ensure the home is run in their best interests. Information supplied by the registered provider within the AQAA evidenced that resident’s health and wellbeing is promoted by effective routine maintenance. Nottingham Neurodisability Services Aspley DS0000059536.V349246.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 2 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 1 23 2 ENVIRONMENT Standard No Score 24 3 25 2 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 x 34 2 35 2 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 2 X 3 1 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 x 16 x 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 3 2 X 2 x 3 x x 3 x Nottingham Neurodisability Services Aspley DS0000059536.V349246.R01.S.doc Version 5.2 Page 26 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA1 Regulation 5 Requirement To ensure residents can determine the suitability of the service in meeting their needs the Service User Guide must be updated to include the current fees charged. The promote the safety and well being of all residents, care plans for each resident must be formulated which sets out the residents specific needs and how the needs can be met by the resources of the care home. Resident’s decisions must be respected and routines must be flexible to ensure residents can make independent decisions relating to the care they receive. To promote the health and wellbeing of resident’s personal details relating to the residents health care provision must not be openly discussed in communal areas. Residents must be provided with adequate quantities of suitably wholesome and nutritious food, which is varied and satisfies the resident needs and preferences. To promote the physical and DS0000059536.V349246.R01.S.doc Timescale for action 30/11/07 2 YA6 15 30/11/07 3 YA7 12 30/11/07 4 YA10 12 30/11/07 5 YA17 16 30/11/07 6 YA18 12 30/11/07 Page 27 Nottingham Neurodisability Services Aspley Version 5.2 emotional needs of the residents Staff must not use disrespectful language whilst on duty. Staff must not sleep whilst on night duty. 7 YA20 13 To promote the health and wellbeing of residents, medication management must be safe. The temperature within the medication fridge must be maintained within 2-8 degrees centigrade. Medication Administration Records must be maintained in accordance with policies and procedures. 8 YA22 22 Outstanding from 30.11.06 Complaints must be managed according to policies and procedures to ensure that residents and their relatives are confident that concerns and complaints are listened to, taken seriously and acted upon. Residents must not feel intimidated by staff when making a complaint. To promote the health and wellbeing of resident’s new staff must only be employed following completion of satisfactory police checks and two written references. Outstanding from 29.08.06 To promote the health and wellbeing of resident’s staff at the home must receive regular and formally recorded supervision to ensure staff are able to carry out their duties effectively. To promote the health and DS0000059536.V349246.R01.S.doc 30/11/07 30/11/07 9 YA34 19 30/11/07 10 YA36 18 30/11/07 11 YA37 Schedule 30/11/07 Page 28 Nottingham Neurodisability Services Aspley Version 5.2 2 12 YA37 24 wellbeing of the residents the acting manager must apply for registration with CSCI. To promote the health and wellbeing of residents effective quality auditing procedures must be performed to ensure that the quality of care provided at the home is reviewed at appropriate intervals and systems are in place for improving service provision. 30/11/07 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 YA25 Good Practice Recommendations Secure lockable facilities should be made available in resident’s bedroom to provide a secure environment for resident’s valuables. To promote the health and wellbeing of residents 50 of care staff should hold a care National Vocational Qualification (NVQ) 2 or above or are working to obtain one by an agreed date. YA35 Nottingham Neurodisability Services Aspley DS0000059536.V349246.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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 Nottingham Neurodisability Services Aspley DS0000059536.V349246.R01.S.doc Version 5.2 Page 30 - 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!