Inspection on 19/07/05 for Outlook House

This inspection was carried out on 19th July 2005.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Outlook House 28/09/06

Outlook House 15/02/06

Outlook House 04/03/05

Outlook House 14/09/04

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 Outlook House 74 Redhill Drive Brighton East Sussex BN1 5FL Lead Inspector Jane Jewell Unannounced 19 July 2005 13.20 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 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 Stationary 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. Outlook House H59-H10-S14219 Outlook House V230628 190705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Outlook House Address 74 Redhill Drive Brighton East Sussex BN1 5FL 01273 555252 01273 558676 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) The Outlook Foundation Vacant Care Home 15 Category(ies) of Learning disability (LD), 15 registration, with number of places Outlook House H59-H10-S14219 Outlook House V230628 190705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. The maximum number of service users to be accommodated is fifteen (15). During six one-week periods throughout a calendar year, for the purposes of assessment visits only, the number of service users accommodated can be sixteen (16). 2. 3. Service users must be aged between eighteen (18) and twenty five (25) years on admission. Service users with a learning disability only to be accommodated. Date of last inspection 4 March 2005 Brief Description of the Service: Outlook House is registered for up to fifteen young adults between the age of eighteen and twenty-five years old who have a learning disability. The home offers a programme of further education and life and vocational skills over a maximum period of seven years. This is with the intention of residents developing sufficient skills and confidence to be able to live an independent life as is possible when they leave. The Outlook Foundation, a registered charity established the home in 1997. The Foundation has also developed properties into independent living flats for some residents to move into upon completion of the programme at Outlook House. Outlook House is a large detached Edwardian property located on the outskirts of Brighton. It is presented over four floors, basement, ground floor, first and second floors, with resident’s accommodation consisting of fourteen single bedrooms and one Bed-sit. Communal space includes a large lounge and dining room, music room, conservatory, resident kitchen, home economics room, a learning centre and a large terraced rear garden. The home owns two mini buses and a car. The homes literatures states that the home is dedicated to quality living and training in preparation for independence, appropriate to individuals ability. Outlook House H59-H10-S14219 Outlook House V230628 190705 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced routine inspection, which was undertaken between 1.20pm to 7pm. The inspection was undertaken with John Borthwick (Acting manager) and in part by Jean Marshall (Provider). There were fifteen residents living at the home. The inspection involved a tour of the premises, examination of the homes records, discussion with management, consultation with four staff and seven residents. The focus of the inspection was to look at the experiences of life at the home for people living there. In order that a balanced and thorough view of the home is obtained, this inspection report should to be read in conjunction with the previous inspection reports. The Inspector would like to thank the residents, staff and management for their assistance and hospitality during the inspection. What the service does well: What has improved since the last inspection? There were few areas for the home to improve on as many of the National Minimum Standards are consistently being met at inspection. The one area that was required to be improved was to develop a system to monitor and review the quality of services provided. This is to ensure that the home regularly reviews its performance against its own procedures and aims. Although comprehensively developed it has not yet been fully implemented. Outlook House H59-H10-S14219 Outlook House V230628 190705 Stage 4.doc Version 1.30 Page 6 What they could do better: All residents need to have identifiable goals and the targets leading to their attainment. This is to ensure that resident’s developmental needs are constantly being updated to enable maximum independence upon completion of the programme. Some medication practices need to be improved in order to evidence a clear audit trail of medication and thus ensure that residents are safeguarded by the homes practices. Following the draft inspection report no action plan was provided by the provider, within the timescales set, detailing the action to be undertaken to address the shortfalls in practices noted in this inspection report. 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. Outlook House H59-H10-S14219 Outlook House V230628 190705 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Outlook House H59-H10-S14219 Outlook House V230628 190705 Stage 4.doc Version 1.30 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 standard(s) 1,2, 3 and 4 Prospective residents and their representatives have the information they need to make an informed choice about whether to live at the home and are invited to stay at the home before making a decision. Residents are admitted to the home following a comprehensive assessment process to identify needs and the suitability of the candidate for the programme. The home is able to clearly demonstrate that it can meet the needs of current residents. EVIDENCE: There is a range of well-documented information about the home and the services it provides, this includes a statement of purpose and service user guide, which are displayed and given to prospective residents, their representatives and other interested parties. There is a waiting list to join the programme and many referrals are made. There is a clear admissions criteria in line with the homes aims and objectives and registration. Referrals first go to a panel for initial consideration. The panel is made up of a variety of professionals whom collectively have considerable experience in caring for people with learning disabilities. Those selected are then invited for a week’s assessment visit at the home. An individual assessment programme is developed for each visit, which covers standard skills, travel and education. One resident spoke of having numerous visits to the home to help make up their mind as to whether they wanted to live there. Outlook House H59-H10-S14219 Outlook House V230628 190705 Stage 4.doc Version 1.30 Page 9 In order to be able to meet the needs of one resident who has recently been assessed, Makaton training is being arranged in order that the staff are fully able to communication prior to the resident moving into the home. The first six weeks of residency is looked upon, as a trial occupancy culminating in a formal review of care needs with residents, their representatives and care managers. Further reviews are held at three and six months within the first year of admission. The home does not accept emergency referrals. The home is able to clearly evidence that it meets the needs of residents accommodated. Where it has been identified that additional support is needed to meet the changing or emerging needs of residents then this has been sought promptly. All residents consulted said that they were happy living at the home and described their experiences, as “I like living here” “very happy” “I like all the other people here” “I have made friends here” and “I am glad that I came to live here”. Outlook House H59-H10-S14219 Outlook House V230628 190705 Stage 4.doc Version 1.30 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7, 8 and 9 Comprehensive information is gathered about each resident to guide staff on the personal and development needs of each individual. The general organisation of care plans needs further work to ensure that residents all have achievable goals to aim for and that current information is easy to retrieve. There is a well-developed system in place for enabling residents to take responsible risks in order to enhance their lives. Evidence is available to demonstrate that staff respect residents right to make decisions and residents are active participants in the running of the home. EVIDENCE: Four care plans were sampled which showed that comprehensive information is compiled about each resident into an individual plan and a life skills plan. Combined these provide comprehensive guidelines for staff on the health, personal, social and development needs of residents. It is recommended that old care plan information be archived to assist in the ease of identifying current needs. The life skill plans includes identifiable goals and the targets leading to their achievement. However it was not always clear what further goals had been agreed once the initial goals have been obtained. Outlook House H59-H10-S14219 Outlook House V230628 190705 Stage 4.doc Version 1.30 Page 11 It was discussed that due to one of the central aims of the home being to develop resident skills the regular setting of goals is essential to achieving this. Therefore it has been required that there is regular development of goals for all residents. Named workers undertake monthly reviews of the life skills plan and update them to reflect any changes in needs. It was reported that one resident chairs their own monthly review, however reviews were not signed by residents and in some cases staff. It is recommended that residents sign their monthly review to indicate their involvement and agreement to its contents. A daily diary is maintained for each resident, this provides an account of the actions and events that have occurred. It was previously recommended that staff print their names underneath all signatures made in residents records. However it was still not always clear which staff had recorded, as not all records were signed or illegibly initialled. It remains recommended that staff clearly and legibly sign when they have made a written record. This is to promote accountability and to be able to identify the staff member. Comprehensive risk assessments on core and specialist risks are undertaken including how identified risks will be managed and are reviewed regularly. Risks noted by the inspector during the course of the inspection had already been identified by the home and appropriate action taken to manage. Residents spoke enthusiastically of passing certain risk assessments in order that they could then go out independently or cook a meals by themselves. They said that this made them feel safe as they were only permitted to do such tasks if staff felt that they were able. Residents gave many examples were staff have supported them to make decisions for example in reference to which college courses to take, friendships, finances and how to celebrate a birthday. All residents said staff provided guidance only and allowed them to make the decision themselves. Residents spoke of regular residents meetings where house rules were discussed and agreed. Residents have an agreed list of chores that they are responsible for eg clearing tables, cleaning bedrooms, washing up and all felt that they are encouraged to be involved in the day to day running of the home. Two residents were busy organising a party at the home for a staff member who was leaving. They were responsible for organising the music for the event. Outlook House H59-H10-S14219 Outlook House V230628 190705 Stage 4.doc Version 1.30 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14,16 and 17 Considerable focus is given to providing opportunities for residents to maintain and develop social independence, communication and living skills, through formal education, leisure and life skills programmes. This underpins the principal aims of the home, to equip residents with the necessary skills for more independent living and is to be commended. There is a number of house rules which all residents consulted said they agreed with and needed in order to live together. Dietary needs of residents are well catered for with a balanced and varied selection of food available that meets resident’s tastes and choices. EVIDENCE: Residents undertake various college courses at nearby further education centres, the choice of course is largely determined by residents. The home is also an approved satellite centre by Sussex Downs College, which enables courses to be held at the homes development centre, run by approved tutors. These courses can therefore be tailored towards the individual needs of residents attending and have included numeracy, literacy, information technology and home economics with some leading to formal qualifications. At the time of inspection residents had just broken up for the summer holidays and were looking forward to the summer break. Outlook House H59-H10-S14219 Outlook House V230628 190705 Stage 4.doc Version 1.30 Page 13 Some spoke of going on holidays with their families others said they were just looking forward to having a break from college and staying at the home. All residents consulted felt that the college courses they undertake are meaningful and one resident spoke that the course would help them to get a job at the end of his programme at the home. Residents spoke of the many leisure activities they are involved in including local clubs and accessing pubs, restaurants, bowling and swimming. One resident had just returned from participating in the disability Olympics. In addition foreign day trips have been organised as well as holidays. Residents spoke enthusiastically about their involvement in the recent summer fare held at the home. All residents said that they lived busy lives and felt that they were enabled to arrange their own leisure time as they wish. Residents consistently spoke of the rules of the home for example in relation to the expectable level of noise from audio equipment, no bullying, no swearing, time friends are allowed to visit and visiting other residents bedrooms and time to get up when at college. Two residents had a set time in which they played on their games equipment together. All residents felt that these rules were fair and were important for communal living or to help them to eventually live by themselves. The main kitchen was well equipped and provided suitable facilities for catering. In addition to the main kitchen there is a residents kitchen and home economics room. As well as the home economics room being used by three resident to prepare their own meals, it is also used as a training and life skills room. A cook is employed who develops the menu’s, which were reported to be based on the known likes and dislikes of residents. Records of meals provided showed that individual preferences are catered for eg vegetarian along with specialists diets eg weight reduction. As well as residents undertaking their own shopping when preparing their own meals other residents are involved in the main shopping. Mealtimes remain an important part of the day with staff regularly taking meals with residents. Meal times are flexible, within reason, to accommodate individual residents lifestyles. Residents described the food as “Very good” “I love the food” “Some times we have parties with really nice food” and “You can ask for more if you really like something”. As well as the main meal, snacks and drinks are available for residents to access. In addition many residents prefer to buy their own snacks. The inspector was informed by residents that these are kept in the resident’s kitchen as food is not permitted to be kept in bedrooms. Some residents spoke of asking the staff when they can access these but said they had never been refused. Outlook House H59-H10-S14219 Outlook House V230628 190705 Stage 4.doc Version 1.30 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19 and 20 Personal support is provided in ways that promote and protect resident’s privacy and dignity and independence. The health needs of residents are well met with evidence of regular input from health care professionals. Residents are encouraged and supported to maintain control over their own medicines. Where the home administers medication further work is needed to ensure that a clear audit of medication can be evidenced. EVIDENCE: With all residents having a varied individual daily programme this involves considerable organisation in order to ensure that residents are suitably supported. Whether the support is needed to accompany a resident out or to supervise them whilst at home undertaking life skills. Through observation and discussion with residents this support is provided in a manner consistent with residents individual plans and which respects residents privacy and dignity. The allocation of named workers for each resident’s enables consistency and continuity of support offered. Residents all knew who there named workers were and felt encouraged and supported by them. Residents are registered with a variety of local GP’s. Support is given to attend appointments and staff accompany residents to consultations only upon the invitation of the resident. Care plans include details of resident’s health needs and the steps taken by the home to manage them. Outlook House H59-H10-S14219 Outlook House V230628 190705 Stage 4.doc Version 1.30 Page 15 Records indicate that there is regular input from health care professionals, including GP’s, specialist nurses, dentists and community health care teams. It remains clear that where there are concerns regarding the health or welfare of residents medical advice or intervention is sought promptly. Much good practice was observed in the recent management of medical intervention for one resident, where the resident’s rights to choice were strongly preserved and much effort paid to preserving dignity. Following the medical intervention much analysis work was undertaken on how this situation was managed to identify if any improvements could have been made. This is to be commended. For some residents self-medicating is part of an assessed need which is supported by written risk assessments and appropriate measures to safeguard residents. Medication Administration Records (MAR) provide clear instructions when medicines are to be administered however several examples were noted whereby staff had not signed them to indicate that they had administered medicines. Unidentifiable medication had been left loose in the medicines cupboard. The provider was immediately required to establish why this had occurred as it could not be established who this medication belonged to. Medication stored awaiting disposal from the pharmacy was not always appropriately labelled therefore a clear audit trail was not always evident. It has been recommended that the disposals policy be reviewed to include clear instructions on the labelling of medicines awaiting disposal and the reason. Where prescribed instructions had to be hand written these had been checked and countersigned for accuracy by a second member of staff. However the hand writing was often difficult to read. The importance of clear medicines instructions was discussed with the acting manager who agreed to address this with the staff member concerned. Staff receive medication training from the local PCT and undergo a competency check before they are permitted to administer medication. In addition senior staff have recently undertaken specialist medicines training. The pharmacist undertakes quarterly monitoring visits to the home and staff are able to obtain advice and support where needed. The information leaflets that accompany medication are retained in order to help monitor for any side effects. Outlook House H59-H10-S14219 Outlook House V230628 190705 Stage 4.doc Version 1.30 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23 There is a robust system for dealing with complaints and concerns with residents confident to approach any member of staff with concerns they had. There are procedures and practices in place that supports the protection of vulnerable adults. EVIDENCE: The home remains responsive to complaints/feedback and this is used in a positive way to gauge success in achieving the aims and objectives of the home. There is a written complaints procedure in place, which has been developed in an easy to follow format and is displayed around the home. Residents were confident to approach the inspector and were articulate in their feedback regarding life at the home. All residents consulted said they felt happy to approach any member of staff with any concerns. Staff said that nearly all concerns raised by residents were related to aspects of communal living and are addressed promptly. As a result of some concerns raised, this has resulted in changes to house rules for example the permissible volume level of televisions in bedrooms. There are clear procedures in place for staff to follow to report suspected abuse. Staff have also received formal training in adult protection and prevention of abuse and all showed a good understanding of their roles and responsibilities under adult protection. Outlook House H59-H10-S14219 Outlook House V230628 190705 Stage 4.doc Version 1.30 Page 17 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 standard(s) 24, 26,27,28,29 and 30 Residents live in a clean, comfortable and spacious environment with their own possessions around them. The home is decorated and maintained to a high standard. EVIDENCE: The home is located within a residential area on the outskirts of Brighton and within walking distance of some local amenities and bus routes into Brighton. The home is well presented and maintained to a high standard, with some original 1930’s décor features. Much attention is made to maintaining a domestic feel of the home, including artwork made by residents being displayed around the home along with age appropriate furnishings and décor. Most bedrooms were visited during the inspection and were noted to be highly individualised reflecting residents individual tastes and preferences. Residents are able to bring their own furniture and possessions and where the home provides furniture then this is to a high standard. All bedroom doors are fitted with locks and the majority of residents have their own key. Good practices were observed by staffing knocking and waiting for an answer prior to entering any bedrooms. Outlook House H59-H10-S14219 Outlook House V230628 190705 Stage 4.doc Version 1.30 Page 18 There are sufficient number of toilets and bathrooms located around the home to meet the needs of residents. The home provides spacious communal facilities including a lounge, dining room, music room, and conservatory. There is a large well maintained, terraced garden, which has several patios and seating areas, as well as a lawned area, flower beds and a green house. Making this a very attractive social space for all residents to enjoy. The learning centre is located in the grounds of the home, which is used as an additional meeting room and is regularly used and equipped for various training and activities to take place. The home is not designated to offer services to people with physical disabilities and the stairs and other access arrangements would make it unsuitable for residents with permanent restricted mobility. Staff are very mindful of the restrictions the building poses and residents mobility forms part of the assessment criteria of the home. Therefore the use of individual aids and adaptations is currently limited. All areas of the home were observed to be clean with a high standard of hygiene maintained. Residents are largely responsible for cleaning their bedrooms and this forms part of their assessed goals. Suitable laundry facilities are located on site with many residents responsible for laundering their own clothes. Outlook House H59-H10-S14219 Outlook House V230628 190705 Stage 4.doc Version 1.30 Page 19 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,33 and 36 Resident’s benefit from a high quality and dedicated commitment of a well managed and motivated staff team. There is a core group of staff who have worked for the home for many years and who have the collective skills and experience to deliver the services which the home offers. EVIDENCE: Staff consulted had a clear understanding of their roles and responsibilities and how this contributed towards achievement of resident’s goals and the aims of the home. Staffing levels continue to vary each week in accordance with individual programmes and college term times etc. It remains clear that the numbers and deployment of staff are sufficient to meet the aims and objectives of the home and the individual needs of residents. Staff consulted said that they had sufficient time to send with residents individually and residents said that there was always sufficient numbers of staff around to get the support they needed. The provider is addressing the gender composition of the staff team and has recently appointed more male members of staff. Male residents said that they felt confident to discuss male issues with the acting manager. Outlook House H59-H10-S14219 Outlook House V230628 190705 Stage 4.doc Version 1.30 Page 20 There is historically very little staff turnover, however several members of the management team have left or are in the process of leaving. The provider has been proactive in replacing these promptly to minimise effects for residents. The provider reported that a recruitment campaign is also currently in progress and they have had a significant response to local adverts placed. Therefore recruitment will be examined during future inspections. There remains a core group of staff who have worked at the home for many years and who’s stability and experience clearly contribute towards the quality of life for residents at the home. Residents described staff as: “ Some are good fun” “bossy” “helpful and supportive” If there is trouble I can tell staff and they will help me sort if out” “cool” “Excellent” “They help me” “really nice” “I like all the staff” and “great laugh”. Staff said that they are provided with the information they need to undertake their roles and there was clear evidence of effective communication systems in situ. Staff and residents are assigned to a “pod” of which there are two. This makes clear the line management chain for each member of staff and the named staff for each resident. Each pod has an assistant care manager who undertakes the regular formal supervision and performance reviews of staff. They are in turn supervised and appraised by the provider/acting manager. All staff consulted felt well supported by the provider and management team to undertake their roles. There is a structured programme of staff meetings, including meetings of the whole team and separate meetings for specifics roles. Outlook House H59-H10-S14219 Outlook House V230628 190705 Stage 4.doc Version 1.30 Page 21 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) and 42 37,38,39,41 The current management team ensures that a clear sense of leadership and direction is maintained. The management team is proactive in ensuring that the home creates a warm, open, positive and inclusive atmosphere for residents and staff. The homes records were generally well organised and supportive to the effective and efficient running of the home. There was much good practice evident in relation to the management of health and safety matters. EVIDENCE: The registered manager has recently left and in the interim an acting manager has recently been appointed. All residents spoke positively about him with particular reference to his approachability and the fun side to his personality. The acting manager is currently undergoing induction with a senior member of staff prior to them leaving. The provider is also within the home most days and provides a strong sense of leadership and direction. Outlook House H59-H10-S14219 Outlook House V230628 190705 Stage 4.doc Version 1.30 Page 22 The home was found to be conducted in an open and friendly manner with staff feeling confident to approach any member of the management team. The inspector sat in on part of a staff meeting. Staff were encouraged to put their views forward including different ways of working. In line with previous requirements a quality assurance system has been developed to monitor the standards of services provided. Much work has gone into its development and should provide a comprehensive picture of the quality of services provided once implemented. There are many mechanisms in place to seek the views of residents. This includes weekly house meetings, regular reviews with placement authorities and individual residents reviews. All records requested by the inspector were made available and were well organised and supportive to the effective and efficient running of the home and rights of residents with the exception of medication documents and some elements of care planning. There are extensive policies and procedures related to health and safety. The general manager has responsibility for the premises, and much good practice was evident in relation to the management of health and safety matters. This includes clear accident recording, fire procedures in pictorial formal to support residents understanding of what to do in the event of a fire and hot water regulation to prevent accidental burning. Outlook House H59-H10-S14219 Outlook House V230628 190705 Stage 4.doc Version 1.30 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 4 3 3 x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x 3 2 3 3 3 Standard No 11 12 13 14 15 16 17 x 4 3 3 x 3 3 Standard No 31 32 33 34 35 36 Score 3 x 3 x x 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Outlook House Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score 2 3 2 x 2 3 x H59-H10-S14219 Outlook House V230628 190705 Stage 4.doc Version 1.30 Page 24 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. 2. 3. Standard 6 20 20 Regulation 15(1) 17(1)(a) Sch 3(i) 13(2) Requirement That all residents have clearly identifiable goals and the targets leading to their achievement. That a record is maintained each time medication is administered to a service user. That all medication stored is appropriately labelled with the residents name, medication name and dosage times. Timescale for action 30-09-05 Immediate Immediate 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. 3. 4. Refer to Standard 6 6 6 20 Good Practice Recommendations That staff clearly and legibly sign their name when making any written record in the homes documentation. That old care plan information is archived or kept separate from current service users care plan information. That service users sign their monthly review to indicate their involvement and agreement to its contents. That the disposal of medicines policy be reviewed to include clear instructions on the labelling of medicines awaiting disposal and the reason for disposal. Outlook House H59-H10-S14219 Outlook House V230628 190705 Stage 4.doc Version 1.30 Page 25 Commission for Social Care Inspection 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. 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