Inspection on 07/03/06 for Nutley Hall

This inspection was carried out on 7th March 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 no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Nutley Hall 17/01/07

Nutley Hall 19/07/05

Nutley Hall 03/03/05

Nutley Hall 23/06/04

Nutley Hall 13/10/03

Nutley Hall 09/01/03

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

CARE HOME ADULTS 18-65 Nutley Hall Nutley Uckfield East Sussex TN22 3NJ Lead Inspector Mike Flint Announced Inspection 7th March 2006 10:00 Nutley Hall DS0000021176.V276938.R01.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 Nutley Hall DS0000021176.V276938.R01.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. Nutley Hall DS0000021176.V276938.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Nutley Hall Address Nutley Uckfield East Sussex TN22 3NJ 01825 712696 01825 713469 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) Nutley Hall Limited Mr Paul Bradford Care Home 33 Category(ies) of Learning disability (33) registration, with number of places Nutley Hall DS0000021176.V276938.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The maximum number of residents to be accommodated is thirty three (33) All residents accommodated will have a learning disability. That a maximum of seven (7) residents can be accommodated over the age of sixty-five as long as their individual needs can be met and are regularly reviewed. 19th July 2005 Date of last inspection Brief Description of the Service: Nutley Hall is made up of seven independent living units with each house being shared by residents with live-in support workers. The Main House is a detached Victorian building set in three acres of grounds. The home was founded in 1959 as a residential centre for people with learning disabilities, set up to run and developed according to anthroposophical principles that seek to optimize physical and mental health and well-being in each individual. The home is situated on the A22 in the centre of the village of Nutley about five miles north of Uckfield and overlooks the Ashdown forest. In addition to the residents accommodation there a number of different workshops and a bakery with shop, which is open to the public. Nutley Hall is essentially a community of residents and staff living and working together which has grown and developed organically over a number of years. Several staff and service users have lived at Nutley Hall for many years. The organisational structure is non-hierarchical although the Registered Manager is ultimately responsible for running the service. Nutley Hall DS0000021176.V276938.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection was carried out by two Inspectors over 7 hours during a day in early March, when there were thirty-two residents accommodated, in the age range of twenty-one to seventy-eight years. The Chairman of the Board of Trustees was present to greet the Inspectors, who, together with the registered manager and two senior staff reviewed the developments at Nutley Hall, since the last inspection. The Inspectors subsequently inspected different aspects this residential centre, separately then joining residents, in two of the households for their midday meals. During the course of the visit, a number of residents were spoken with. The manager, senior staff and some of the house-parents assisted throughout the day. A total of eighteen comment cards, or letters were received by the Inspectors from parents, prior to the inspection; there were a further five from residents. Overall the comments made reflected most favourably on the services provided at Nutley Hall. Additionally health and social care professionals, who visit the centre, were contacted as part of the Inspectors’ evidence gathering. A selection of care plans, records and policy documents was inspected. What the service does well: What has improved since the last inspection? The systems and documentation used for care planning and assessing risks are of a high standard; a revised care-plan format is in process of being introduced in order to achieve consistency in recording methods, across the seven households. Two new trustees have been appointed and there have been additional staff posts created and filled. A part-time assistant handyman is now employed. There has been some redecoration carried out at the rear of the main house and in three residents’ private rooms. The manager confirmed that the required window restrictors have been fitted for the safety of residents with up-stairs rooms. Nutley Hall DS0000021176.V276938.R01.S.doc Version 5.1 Page 6 What they could do better: The home’s Statement of Purpose has been revised, providing up-to-date and detailed information for parents, funding authorities and other interested parties. However, there is no similar information available, presented in a format suitable for the people for whom the home is intended i.e. a residents’ guide; likewise within the care planning documentation it is recommended that the section on ‘goal planning’ be produced, using a method that may be understood by the residents concerned e.g. the use of symbols for which there is recognised IT software available. Regular, monthly performance-monitoring visits are carried out and recorded by the Chairman. Ways in which quality assurance processes may be further developed were discussed during the inspection. Also discussed were the additional measures that are required as evidence of the success of Nutley Hall in meeting its aims and objectives; in other words, using quality monitoring as a means of reviewing progress and taking actions that will further improve the overall outcomes for the residents. To this end, the use of survey questionnaires, seeking feedback from residents, relatives and visiting professionals is recommended. A significant number of residents have epilepsy and risk assessments are in place for reducing risk of injury during a sustained seizure. However, there was a lack of guidance recorded for the instruction of staff, in the event of seizures occurring. A review of policy documents is also recommended, to ensure that the information and advice given is current and clearly linked to practice. The Inspectors thank the Chairman, the manager, staff and residents for their participation, willing co-operation and hospitality shown, during the course of the inspection. Thanks also to those parents and Healthcare professionals who have contributed their comments, in respect of Nutley Hall. Some amendments have been incorporated in the final report, following the home’s response to the draft report, where inaccuracies had been noted. 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. Nutley Hall DS0000021176.V276938.R01.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 Nutley Hall DS0000021176.V276938.R01.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): 1, 2, 3, 4, 5 People who are referred to the home are fully assessed enabling decisions to be taken in respect of the home’s ability to meet individual resident’s needs. EVIDENCE: The home’s Statement of Purpose has been recently revised and updated, providing a comprehensive and well-presented summary of the care service provision that is Nutley Hall. Following on from this, it is recommend that a ‘residents guide’ may be collated from the available, existing information, and produced in a format with the potential to enhance the levels of understanding amongst those for whom the information is intended. This could then be combined with a more readily accessible form of contract for residents, including the terms and conditions, which they may then ‘sign up to’. The records inspected showed that the pre-admission assessments, carried out to ensure the home can meet an individual’s presenting needs, are thorough; staff were able to confirm that care is taken also to ensure compatibility between any new resident and the existing group with whom they are to share one of the seven separate houses. All parties concerned are consulted with before any decisions are taken e.g. the applicant, their next-of-kin, their caseworker and the prospective houseparent. Psychological and social care assessments may also be included as part of this process, prior to admission; that, usually being for a trial period, following visits that are arranged for the individual to meet with other residents and the staff, within the different households. Nutley Hall DS0000021176.V276938.R01.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, 7, 8, 9 The staff have a good understanding of the residents’ support needs and this is evident from the positive relationships, apparent between staff and residents. EVIDENCE: The majority of residents are able to take part in meaningful discussion with their support worker, or houseparent regarding their care needs and how these are to be met. Staff spoken with said that wherever possible, encouragement is given for residents to indicate their preferences and to make informed choices. It is recommended this process may be further developed through the use of pictograms and symbols, as an aid to better understanding, when goalplanning documents are being produced. In this way the rights of each resident may be better protected with their being involved in decisions concerning everyday choices, staff support being provided as needed in confirming individual weekly programme of activities. Daily routines and activities are agreed in the context of detailed risk assessments, recorded as part of care planning. All individual risks are assessed in a continuous process that ensures unacceptable risks are avoided. The home has developed a comprehensive system of risk management, which was seen to be well documented within the context of care planning. Nutley Hall DS0000021176.V276938.R01.S.doc Version 5.1 Page 10 Within their capabilities, residents are encouraged to participate in the day-today running of their home e.g. with household tasks, cleaning and laundry. The Inspectors were told that the introduction of any proposed changes in response to a resident’s expressed, or perceived needs are discussed during handovers and at the weekly staff meetings. Support staff receive training in care planning and risk assessment as part of their foundation training. Nutley Hall DS0000021176.V276938.R01.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): 11, 12, 13, 14, 15, 16, 17 Residents lead a fulfilling life, where both the in-house workshops and community activities provide a source of variety and pleasure for residents. EVIDENCE: The ethos of the home is to provide an enabling environment that provides encouragement for residents to aspire towards their potentials. Each of the residents spoken with commented highly of the care at Nutley Hall, some saying that they felt ‘valued and important’ in the running of the home and the smaller units. They said that they can choose the activities that they wish to participate in, or not, what clothing they would like to wear and, initially upon admission, which bedroom they would prefer and the colour scheme. One of the residents spoke freely about a recent birthday, which the home had organised a party for; cards, gifts and a special day out were arranged. The Inspectors felt a real sense of community participation within Nutley Hall, where everyone appears to have a valued contribution to make towards life within the home. Nutley Hall DS0000021176.V276938.R01.S.doc Version 5.1 Page 12 The Inspectors were shown the on-site workshops, where residents were occupied in a variety of activities. These include candle making, bakery, weaving, gardening, woodwork, making furniture and musical instruments. In addition an education class was being held; the manager said that emphasis is placed on writing skills and awareness of the wider world. The Inspectors met the music therapist, employed to work at the home. A house-parent commented on the emphasis given to achieving a structure and ‘rhythm’ to the working week that enabled residents to be more independent. A number of offsite activities take place, including horse riding, swimming walking and most recently woodland ‘coppicing’ in the nearby Ashdown Forest. The overall provision of meaningful activities is commendable. The Inspectors suggested the home consider the pre-NVQ training syllabuses that are available in a very wide range of subjects through the National Proficiency Test Council i.e. covering many of those activities already being undertaken at Nutley Hall (see NPTC website). In this way residents may be able to experience a sense of achievement better i.e. by working towards completing certificated course work. Nutley Hall has become part of the local community. Many of the residents said that they are often now greeted by familiar faces from the village either onsite, in a number of the local shops, or the local pub. The Nutley Hall bakery shop has been open to the general public since 1992. The Inspectors were invited to join with residents and support staff in a lunchtime meal, in two of the houses. The meal was vegetarian, wholesome and tasty, having been prepared in the central kitchen and distributed between the various houses, using ‘hot boxes’. The vegetables used are grown in the kitchen garden and home baked bread from the bakery is served with most meals. Residents said that they help to plan the supper menus and commented that they enjoyed the food provided at the home. Nutley Hall DS0000021176.V276938.R01.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): 18, 19, 20, 21 The health needs of residents are well met with evidence of good multidisciplinary working with the Community Teams on a regular basis. EVIDENCE: The residents’ care planning documents are in process of being revised, using an improved format, in order to achieve consistency in recording between the different houses. Where there are specific health care needs, residents have received on-going support from medical consultants e.g. in the case of epilepsy. Workers from the Community Healthcare Teams provide therapeutic support and advice to the home. A number of residents living at Nutley Hall have epilepsy and it was pleasing to note that the majority of staff have received training in epilepsy and a number of risk assessments are in place for reducing the risks of injuries sustained during seizures. However, individual epilepsy management guidelines were not recorded; such records are required to include a brief history of the person’s seizures, a description of what form the seizure takes and instructions for staff to follow in the event of a seizure occurring. Three residents’ care plans were examined in some detail and were found to be up to date and current. It was evident through speaking with residents that Nutley Hall DS0000021176.V276938.R01.S.doc Version 5.1 Page 14 they are kept informed and up to date in a language that is easy to understand about their changing health. Two particular residents were ‘case tracked’. Due to increasing healthcare needs associated with learning disabilities, the home has accepted that it can no longer meet their assessed needs and suitable alternative placements are being discussed with respective funding authorities. Both residents have lived at Nutley Hall for many years and the Inspectors commended the home for the way in which their healthcare summaries clearly show a breakdown of events over time, with good guidance for staff to follow in meeting the personal healthcare needs of these two residents. Additional specialist equipment such as a commode, manual handling equipment and bed rails have been purchased for short-term use, whilst alternative placements are sought for the two residents in question. None of the residents have control over prescribed medicines, an exception being in the case of inhaler usage by residents with asthma. The home’s policies and procedures for the administration, recording, storage and handling of medicines is satisfactory. One of the senior houseparents described to the Inspectors the procedures used and said that medical advice is sought from a visiting, anthroposophical doctor, who attends the home on a bi-monthly basis. Nutley Hall DS0000021176.V276938.R01.S.doc Version 5.1 Page 15 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): These Standards were not assessed as part of this inspection. During the last unannounced inspection the Standards were assessed as having been met, at that time. EVIDENCE: Nutley Hall DS0000021176.V276938.R01.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): 24, 28, 30 The overall standard of the environment within this residential centre is satisfactory, providing residents with a safe and homely place to live. EVIDENCE: Although the Inspectors did not visit each of the seven house during this inspection, the overall standard of furnishings and décor in those areas seen was of a good standard; an exceptionally high standard of craftsmanship was to be found in the recently completed ‘Orchard House’ facility, a communal hall with stage, which, the Inspectors were told, is used daily for music, eurhythmy, drama and gym. A wide choice of attractive and well-appointed shared spaces exists within the various buildings, comprising the centre. All areas visited were very clean and a high standard of hygiene appeared to be maintained. House-parents confirmed that residents were encouraged to undertake cleaning and laundry tasks with support from staff. All staff participate in fire safety training and practice fire drills with records kept of those taking part. Nutley Hall DS0000021176.V276938.R01.S.doc Version 5.1 Page 17 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): 31, 32, 33, 34, 35, 36 The staffing structure is good resulting in a diverse, well-supported workforce that works positively with residents to improve their whole quality of life. EVIDENCE: Nutley Hall DS0000021176.V276938.R01.S.doc Version 5.1 Page 18 Since the last inspection there has been minimal staff turnover; a majority of permanent staff have been employed at Nutley Hall for five years, or over. The home employs a substantial number of volunteer co-workers from overseas, all of who are resident in one, or other of the seven houses. The manager confirmed that the required Police checks and references are taken up for all staff as a matter of course. Duty rotas show the overall staffing arrangements to be satisfactory and in keeping with the needs of residents. The Inspectors voiced their concern in respect of the provision of care at night for those residents with deteriorating conditions, in particular with regards to manual handling, there being currently only one waking night staff employed. It is required that the levels of waking night staff be adequate in meeting the needs of residents and that such levels be kept under constant review. The staff employed bring a range of qualities and experience to the home, enabling specialist arts and crafts workshops to be developed for the benefit of residents. These include basketry, woodwork, music and eurythmy therapy. The attitude of staff, observed during the inspection, towards residents was attentive, calm and friendly. There appeared to be a healthy level of mutual respect between the staff and residents. The manager confirmed the home’s commitment to an on-going and comprehensive staff-training programme, including management skills, medicines administration and adult protection training. All care staff progress onto NVQ training, upon completion of their induction and foundation training. Staff receive contracts and detailed terms and conditions of employment; job descriptions are provided, clarifying roles and responsibilities. Individual staff supervisions take place and there are regular, weekly staff meetings. Nutley Hall DS0000021176.V276938.R01.S.doc Version 5.1 Page 19 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, 38, 39, 40, 41, 42, 43 Residents benefit from a non-hierarchical organisational structure and an open management approach in this well run residential centre. EVIDENCE: The management team, including the registered manager, consists of qualified, competent and experienced individuals, who each aspire to the anthroposophical approach to the provision of care within the organisation, encapsulated within the organisations Statement of Purpose. In observing the home’s day-to-day operations, the Inspectors were aware of this particular ethos and leadership style that appeared to bring order and purpose in the lives of the residents, according to their abilities. Upon inspecting some of the home’s policies and procedures, it was apparent that not all of these had been recently reviewed e.g. epilepsy care and personal relationships. It is recommended that these documents, provided for the advice and guidance of care staff, be reviewed on a rotational basis. Nutley Hall DS0000021176.V276938.R01.S.doc Version 5.1 Page 20 As far as it was reasonable to ascertain and from the Inspectors discussions with the Chairman of the Board of Trustees, on the day of the inspection, the Nutley Hall organisation appears well founded, satisfactorily resourced, including infrastructures, and is a responsible provider of specialist care services to a wide age range of adults with learning disabilities. The Inspectors were informed that the Board of Trustees is comprised of individuals from a variety of professional business backgrounds, including the care industry, banking, medicine and education; the Board meets quarterly. Quality assurance processes are satisfactory, including a high standard of record keeping and programme review. The Inspectors were told of a staff member, who is undertaking a Quality Assurance continuation-training course. The Chairman visits the home on a very regular basis, in support of the management team, whilst monitoring and recording the home’s performance on a monthly basis. The Inspectors discussed with the manager the ways in which feedback was being actively sought from residents about the services provided. Residents’ meetings are held every other month. The home has an annual development plan in place and there is an annual newsletter, which is sent out to all interested parties. All senior staff have received suitable training on the giving of supervision, in performance appraisal and in other management skills. Care staff complete training in safe working practices applicable to their employment e.g. adult protection, fire safety, food hygiene, infection control, first aid and manual handling. The Inspectors noted that appropriate attention is paid to ensuring the health and safety of residents through a comprehensive staff training programme and regular review of individual care needs. A senior staff carries out and records regular health and safety checks throughout the centre. Nutley Hall DS0000021176.V276938.R01.S.doc Version 5.1 Page 21 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 X 23 X ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 4 29 X 30 3 STAFFING Standard No Score 31 3 32 3 33 2 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 3 12 4 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 3 4 3 3 3 3 3 3 3 Nutley Hall DS0000021176.V276938.R01.S.doc Version 5.1 Page 22 No 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 YA5 Regulation 5(1) Requirement That the existing information, intended as a service users’ guide, including terms and conditions of residency, be produced in a format suitable for residents/ intended residents. That in the case of residents, who have epilepsy, management guidelines be put in place, including a brief history of the person’s seizures, a description of what form the seizures take and clear instruction for staff to follow in the event of seizures occurring. That night staffing arrangements be kept under review to ensure the safety and well-being of all residents, with particular attention paid to those with a need for high levels of support, both day and night. Timescale for action 01/10/06 2. YA19 12(1)(a) 01/05/06 3. YA33 18(1)(a) 01/04/06 Nutley Hall DS0000021176.V276938.R01.S.doc Version 5.1 Page 23 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 YA5 Good Practice Recommendations That further work is carried out on producing a Service Users Guide that may better convey the required information i.e. in a format more generally suited to residents’ understanding. That the care-plan section on ‘goal planning’ be produced and made available in a format suitable for the understanding of residents, with copies for their retention. That the registered manager ensures all policies, procedures and codes of practice are monitored, reviewed and amended as necessary e.g. ‘sexuality and personal relationships’. 2. 3. YA6 YA40 Nutley Hall DS0000021176.V276938.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 Nutley Hall DS0000021176.V276938.R01.S.doc Version 5.1 Page 25 - 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. 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