Inspection on 06/07/06 for Paddock House

This inspection was carried out on 6th July 2006.

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 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

Paddock House 25/03/08

Paddock House 28/11/07

Paddock House 27/01/06

Paddock House 01/07/05

Paddock House 27/01/05

Paddock House 08/09/04

Paddock House 20/03/04

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

CARE HOME ADULTS 18-65 Paddock House Paddock House 13 Prospect Road Hythe Kent CT21 5NN Lead Inspector Michele Etherton Unannounced Inspection 6th July 2006 09:45 Paddock House DS0000023503.V297480.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 Paddock House DS0000023503.V297480.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. Paddock House DS0000023503.V297480.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Paddock House Address Paddock House 13 Prospect Road Hythe Kent CT21 5NN 01303 230067 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) Mr James Peter McCarthy Mr James Peter McCarthy Care Home 16 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (16) of places Paddock House DS0000023503.V297480.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27th January 2006 Brief Description of the Service: Paddock House is registered to provide accommodation and personal care to 16 adults with a mental health disorder (excluding learning disability and dementia), and is owned and managed by Mr Jamie McCarthy. Paddock House occupies detached premises with sixteen single bedrooms, one of which having ensuite facilities. Accommodation for Residents is on two floors. The frontage of the home opens onto a public pavement, but there is a small garden and seating area at the rear for Residents to use. There are bathing and shower facilities on both floors in addition to a number of toilets throughout the premises. The home is situated centrally in a small costal town, with good access to local shops, pubs, clubs, library, swimming pool and public transport. The current fee for this service is £392.34 per week Paddock House DS0000023503.V297480.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and started at 09.45 am and lasted until 6.05 pm. The majority of residents were at home on and off throughout the day, and seven were spoken with individually. The home was experiencing a crisis with a service user at the time of the visit and much of the first part of the visit was taken up in discussion with the provider and senior staff concerning their frustrations at the lack of appropriate and timely interventions from the Crisis assessment team in responding to this matter. Approximately two hours were spent in speaking with service users and staff. Time was also spent in discussion with the manager, deputy manager and a volunteer, who undertakes much of the administrative and managerial tasks. Time was also spent viewing documentation including staff and service user records, complaints, accidents and medication records, staff and service user meeting minutes, the staff rota. A tour of the premises was undertaken including one service user bedroom. One member of care staff was interviewed privately. A visiting Community Psychiatric Nurse, was spoken with, and the activities coordinator was observed during the visit. Service users reported that “food is good”, “I can do what I like and make my own decisions” “The staff are there if you need them”. What the service does well: What has improved since the last inspection? The home has addressed all outstanding requirements and implemented the majority of good practice recommendations. The home has implemented a programme of upgrading of the building, systems for the recording of service user monies have been developed and implemented providing appropriate audit trails, improvements have been made to the recruitment procedure. Staff Paddock House DS0000023503.V297480.R01.S.doc Version 5.2 Page 6 have received training in adult protection issues, monthly key worker meetings have been implemented and the medication procedure has been amended. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Paddock House DS0000023503.V297480.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Paddock House DS0000023503.V297480.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2,3,4,5 Quality outcomes in this area are good. This judgement has been made using available evidence including a visit to this service. prospective service users are only admitted following a full assessment of their needs, the management team ensure that only those whose needs can be met within the service are admitted. Prospective Service users are provided with opportuntities for introductory visits and trial stays prior to admission. Service users are provided with a contract highlighting the terms and conditions of their stay. EVIDENCE: Three service user files viewed at inspection were found to contain detailed assessment information, background reports and supporting information are also sought by the home to aid their assessment of prospective service users. Discussion with staff involved in the admission of prospective service users indicated an awareness of the limitations of the service in respect of some people referred, and subsequent refusal of referrals of those for whom they the home would be unable to meet specific needs. Paddock House DS0000023503.V297480.R01.S.doc Version 5.2 Page 9 Opportunities are provided to prospective service users to visit and have trail stays prior to admission. Statements of terms and Conditions were noted on user files viewed. Paddock House DS0000023503.V297480.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 Quality outcomes in this area are good. This judgement has been made using available evidence including a visit to this service. Detailed person centred care plans are in place. Service users are consulted regarding aspects of living in the home, supported to make decisions about their lives and encouraged and faciltiated to develop or maintain an independent lifestyle. Risk taking is appropriately assessed. EVIDENCE: User files viewed contained detailed person centred care plans, reflecting individual routines and support needs. Care plans were signed by service users and provided evidence of review. There was evidence of care managers making appointments to meet with service users to review care plans. Survey feedback from health and social care professionals was positive in that they were satisfied overall that the need sof service users were being met within the home. The home will need to consider how it can support appropriately the cultural and personal care needs of those users from other ethnic groups. Paddock House DS0000023503.V297480.R01.S.doc Version 5.2 Page 11 Discussion with service users during the visit, indicated that they are supported by staff to develop their interests and activities outside of the home. CPA review information was also noted on files, the frequency of these being dependent on individual residents needs. A range of risk assessments were noted on all three files viewed, these provided evidence of updating. Paddock House DS0000023503.V297480.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15,16, 17 Quality outcomes in this area are good, This judgement has been made using available evidence including a visit to this service. Service users are encouraged and enabled to develop a range of activities and leisure interests. Service users make good use of local facilities and maintain a community presence. Service users are supported to develop appropriate personal relationships and maintain contacts with families and friends. Service users interact well with each other and staff and actively make decisions about their daily routines including daily menu choices. EVIDENCE: Survey information indicated people were happy with their daily routines and that they have control of these and daily decision making, discussion with service users confirmed that they were satisfied with their individual routines Paddock House DS0000023503.V297480.R01.S.doc Version 5.2 Page 13 some of which are more active than others. Some service users indicated that they enjoy their own company do not wish to participate in organised activities and are somewhat resentful of staff trying to motivate them in some areas, clearly this is a dilemma for staff who are keen not to beintrusive but also need to ensure users do not become overly isolated as this may be detrimental to their overall mental health. Some service users spoken with confirmed they retain contact with relatives and receive visits or undertake home visits, relatives surveyed reported that where they undertake visits to the home they find the staff welcoming and approachable. The home has a day care worker five days per week who enables and faciltiates service users who require additonal supervision and support to make good use of community facilitiesse. Service users were observed coming and going from the building throughout the day some on their own others in the company of the worker, daily record sheets also confirmed that clients are undertaking regular activities and retain a good community presence making use of local leisure and community facilities, one client advised that they have managed to obtain a voluntary job one day per week that fits in with a personal interest of theirs. Despite a level of tension within the home at the time of the visit due to a mental health crisis for one service user, the atmosphere within the home was calm and relaxed with service users interacting well with each other and staff. Users spoken with and surveyed confirmed that they make their own day to day decisions, with those user files viewed reflecting individual personal preferences in respect of daily routines. The home does not produce two weekly menus, service users are asked on a daily basis what they would like for lunch and dinner, users appear to like this arrangement and all of those spoken with expressed satisfaction with the quality and variety of food provided, the home weighs residents regularly and records of this were noted on individual files viewed. Paddock House DS0000023503.V297480.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality outcomes in this area are good, This judgement has been made using available evidence including a visit to this service. Service users personal care routines are in keeping with their personal preferences. Service users are supported and enabled to access routine healthcare appointments, but systems for recording the frequency of this or refusals by users needs to be strengthened. Staff are accredited to provide medication support to service users. Improvements are required to the recording of medications to be administered to ensure the safety of service users is not compromised. EVIDENCE: Discussion with service users indicated that most of those spoken with are able to undertake their own personal hygeine, but need prompting to do so when unwell, this was approprialy reflected in care plans viewed, residents spoken with appeared happy with the level of support needed one reported the support is there if you need it. Paddock House DS0000023503.V297480.R01.S.doc Version 5.2 Page 15 Files viewed evidenced routine and more specialist appointments, although this information was not always recorded consistently in the same place, the home may wish to consider the most appropriate place to record this information so that checks can be made on the regularity of routine appointments for optician, chiropody and dental care, and also where refusals for such appointments are recorded. One client arranges all their own routine health appointments and this needs to be more clearly recorded in care plan. One service user was experiencing a mental health crisis at the time of the visit and staff were proactive in seeking appropriate healthcare interventions to alleviate the situation, this was a source of frustration both to staff and the service user concerned, who found timely external support from Mental health care professionals inadequate. Several of the current service users are over 65 years of age and the home will need to ensure that staff are appropriately trained to meet the needs of older people and their healthcare needs. Staff are trained to an accredited standard to administer Medication. MAR sheets viewed although completed appropriately need strengthening in two areas to ensure the risks of medication errors are reduced and appropriate audit systems are in place. The use of sticky lables from the pharmacist to place on MAR sheets where medication changes have occurred must be discontinued as this is contrary to Pharmacuetical Society guidelines and may pose a risk of medication errors occuring, in addition all handwritten entries by staff on MAR sheets must be signed and dated by the person entering the information a requirement has been issued for these improvements. The home are required to evidence systems are in place for the auditing of medication including liquid medication, the dating upon opening of liquid medications will support the auditing process. Paddock House DS0000023503.V297480.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality outcomes in this area are good, This judgement has been made using available evidence including a visit to this service. The service has a complaints procedure that is clearly written, and is easy to understand, but requires minor updating. Service users demonstrate a good understanding of how to make a complaint. Service users are protected from harm and neglect, staff have received training in abuse issues. The procedure for recording monies received by service users needs.strengthening to ensure accuracy is maintained. EVIDENCE: A complaints procedure is in place and this is openly displayed on the information board within the home. Service users reported through discussion and survey feedback that they knew how and to whom to direct complaints. The complaints record although recording only one complaint within the last 12 months highlighted use of the complaints process by service users with appropriate actions taken by home staff to resolve issues. Some relatives surveyed indicated a lack of awareness about the complaints procedure, and the home may wish to consider how it can make this information more available to relatives and friends. Some minor updating of the complaint procedure is needed in respect of information relating to the Commission for Social Care inspection, this remains an outstanding recommendation. Paddock House DS0000023503.V297480.R01.S.doc Version 5.2 Page 17 The home has addressed an outstanding requirement to provide adult protection training for staff. The home has also addressed an outstanding requirement to develop clearer records in respect of service user monies to enable audit trails to be undertaken. Four balances were checked of service user monies held on their behalf by the home, in three cases balances exceeded the recorded amount by small sums and in a fourth case the balance was less than that recorded, in this instance a service user was able to confirm that they had received the monies, but clearly this had not been recorded by staff. The home are required to ensure that staff maintain accurate recording of service user personal allowance monies at all times, and implement a weekly audit. Paddock House DS0000023503.V297480.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Quality outcomes in this area are adequate. This judgement has been made using available evidence including a visit to this service. The home provides a comfortable and homely environment but this is in need of significant investment and upgrading. The home is generally maintained to a good standard of cleanliness, staff are still to receive infection control training. EVIDENCE: The home provides a comfortable and homely environment to service users, but is in need of significant investment to effect a programme of upgrading. The home has addressed an outstanding requirement to implement a development plan for the upgrade of the building, some upgrading works for the 2006/2007 period are already planned and these include the replacement of three bedroom windows by double glazed units and the external painting of the home. Consideration should be given to the upgrade of the furnishings within the building which are also showing signs of wear and tear, as part of an overall upgrade of the environment. Paddock House DS0000023503.V297480.R01.S.doc Version 5.2 Page 19 The home has addressed a previous recommendation in respect of replacement /repair of locks in a bathroom and a service user bedroom Discussions with service users indicated that apart from minor frustrations most are satisfied with their rooms and have personalised them to reflect their own tastes and interests, users confirmed that they are asked about how they would like their room decorated, colour scheme etc., one service user expressed their willingness for the inspector to view their room and this was clean, tidy and organised into a sleeping and leisure space by the user concerned, they reported they had everything they needed currently within their room. Users reported that there are delays sometimes in the addressing of minor repairs e.g. broken curtain rails etc, “ it seems to take a long time to get something done, like putting a curtain rail up”, the home does not currently have a maintenance person, although are trying to recruit for this position, at present repairs’ are carried out by a senior staff member or a qualified tradesman as required. The home has a maintenance book and it is recommended that this is kept updated to ensure that time scales for completion of repairs can be monitored effectively. At present none of the current service users require specialist equipment to support their care needs, the home will need to keep this under review due to the advancing age and mobility of several of the service users. Service users reported through discussion and surveys that the home was always or usually maintained to a good standard of cleanliness. On the day of the visit the home was generally clean and tidy with no obvious unpleasant odours. Service users are actively involved in the process of laying tables for dinner and clearing them afterwards, home staff should monitor for infection control purposes that the cleansing of tables has been undertaken robustly, as it was noted during the visit that some tables were in need of further cleaning. Staff are still to receive infection control training. Paddock House DS0000023503.V297480.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33, 34,35 Quality outcomes in this area are good. This judgement has been made using available evidence including a visit to this service. The home has a programme of NVQ2 training and 50 of staff have achieved NVQ2. The staff team are well motivated and committed. Stated user dependency and current staffing levels are not in keeping with Care homes staffing tool. A robust system of recruitment is in place. New staff are provided with appropriate induction, this needs reviewing against new sector skills induction standards. A programme of training is in place for staff but improved clarity is needed in the recording of individual staff training to ensure all staff have achieved mandatory core skills. Staff are well supported and receive regular supervision. EVIDENCE: Paddock House DS0000023503.V297480.R01.S.doc Version 5.2 Page 21 The home has advised through pre-inspection information provided that four of the seven staff have achieved NVQ2. A staff member spoken with confirmed they had been supported to undertake NVQ 2. The stated dependency levels of the user group compared to the current staffing levels are not in keeping with staffing levels proposed by the care homes staffing tool and it is a recommendation that this is reviewed. Despite this feedback from service users, relatives and health and social care professionals highlighted no issues in respect of staffing. Staff spoken with during the visit reported that current staffing levels were satisfactory and that where needs changed and higher levels of supervision etc were required on a short term basis staffing was adjusted to reflect this. Discussions with service users during the visit also indicated no concerns in respect of accessibility and availability of staff. The home has addressed an outstanding requirement from the last inspection to implement a recruitment checklist. Two of the newest staff files were viewed and appropriate checks and documentation were in place. The home has developed an induction training programme for new staff, they will need to review this to ensure it is in keeping with the new induction standards set by the sector skills council and mandatory from September 2006. The home has a training matrix and records training offered over the year to staff, this is insufficiently clear to enable a judgement to be made as to whether all staff have now achieved or updated mandatory core training skills, it is recommended that the home reintroduce individual training profiles for staff in keeping with standard 35.5, to strengthen the clarity and recording of individual staff training records. Staff spoken with confirmed supervisions are being undertaken on a regular basis and staff files evidenced records of these. Paddock House DS0000023503.V297480.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38,39 42 Quality outcomes in this area are good. This judgement has been made using available evidence including a visit to this service. The Registered provider/manager has the necessary experience to run the home and undertakes some periodic training, he has not indicated a willingness to complete a Registered Manager Award. Service users benefit from the ethos of the home, staff feel well supported and staff morale and commitment are good Service users are routinely consulted about the service and their views are influential on the development of the service. Quality monitoring needs strengthening to incorporate evidence of self audit of systems. The home generally has a good record of meeting relevant health and safety requirements and legislation, however, this visit highlighted the frequency of electrical inspections has slipped. EVIDENCE: Paddock House DS0000023503.V297480.R01.S.doc Version 5.2 Page 23 The provider/ manager has a professional health qualification and has participated in periodic specific training, he has to date demonstrated an unwillingness to underake the RMA. Service users benefit from a user focused service, that is inclusive and seeks their involvement and participation. Staff morale appears good and staff turnover has been low, a staff member spoken with during the visit who will be leaving, reported that “ if it wasnt for the fact that I am emigrating, I would be happy to stay here and develop my care practice in this environment, which I find interesting and supportive”. Staff spoken with confirmed Staff meetings are held routinely and minutes of these were viewed. Service users have opportunities through annual surveys twice yearly, regular user meetings and monthly key worker meetings to express their views. The home undertakes analysis of annual user surveys and produces a report of findings, this is made available to service users on their information board, along with a copy of the last inspection report. The existing quality assurance and quality monitoring will need strengthening to evidence clearly that systems are in place for self monitoring, and should incorporate, medication, service user monies, etc. The home has attested in preinspection questionnaire that all health and safety checks and servicing have been undertaken, through some confusion in respect of servicing frequencies the electrical wiring has not been serviced for several years, the home were reminded that they should be instituting checks of the electrical system at least annually unless advised otherwise by a qualified electrician, a requirement has been issued in respect of this. Senior staff indicated that weekly Health and safety checks and tests are undertaken. Accident records were reviewed these indicated a low level of service user accidents in the past twelve months. Paddock House DS0000023503.V297480.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 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 3 23 2 ENVIRONMENT Standard No Score 24 2 25 X 26 3 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 x 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 x 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 2 X 3 X X 2 X Paddock House DS0000023503.V297480.R01.S.doc Version 5.2 Page 25 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 YA20 Regulation 13 Requirement The use of sticky lables from the pharmacist to place on MAR sheets where medication changes have occurred must be discontinued, home to discuss with pharmacist. All handwritten entries by staff on MAR sheets must be signed and dated by the person entering the information. Home to implement routine auditing of medications and this should include liquid medications, the dating upon opening of liquid meds will support this The home are required to ensure that staff maintain accurate recording of service user personal allowance monies at all times, and will need to consider how distractions to staff can be reduced to support this. Home to ensure that servicing of electrical wiring system is undertaken a minimum of yearly unless stipulated otherwise by a qualified electrician. Servicing to be arranged for this year at the DS0000023503.V297480.R01.S.doc Timescale for action 31/07/06 2. YA23 13 31/07/06 3. YA42 13 31/07/06 Paddock House Version 5.2 Page 26 earliest opportunity 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 YA22 Good Practice Recommendations Home to update complaint procedure to reflect Commission for social Care inspection information and local office address changes (outstanding from previous inspection) It is recommended that the home ensure the maintenance book is kept updated so that time scales for completion of repairs can be monitored effectively. The home to review user dependencies and staffing levels in conjunction with Care homes staffing tool, the home will need to evidence this and how they have determined final staffing levels The home reintroduce individual training profiles for staff in keeping with standard 35.5, to strengthen the clarity and recording of individual staff training records. 2. YA24 3 YA33 4 YA35 Paddock House DS0000023503.V297480.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Kent and Medway Area Office 11th Floor International House Dover Place Ashford Kent TN23 1HU 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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