Inspection on 18/12/06 for Phillips House

This inspection was carried out on 18th December 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Phillips House 18/11/08

Phillips House 09/03/06

Phillips House 02/08/05

Phillips House 01/02/05

Phillips House 19/08/04

Phillips House 18/02/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Phillips House 5 Jesmond Road Clevedon North Somerset BS21 7SA Lead Inspector Catherine Hill Unannounced Inspection 18th December 2006 14:00 Phillips House DS0000008111.V311729.R02.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 Phillips House DS0000008111.V311729.R02.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. Phillips House DS0000008111.V311729.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Phillips House Address 5 Jesmond Road Clevedon North Somerset BS21 7SA 01275 873447 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) Freeways Trust Limited Ms Nicola Anne Jones Care Home 13 Category(ies) of Learning disability (13) registration, with number of places Phillips House DS0000008111.V311729.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. May accommodate up to 13 persons aged 18 - 65 years with Learning Disabilities May accommodate one named person over the age of 65 for respite care only. Conditions of Registration will revert to age group 18 - 65 when this person leaves Mrs Jones should have monthly support from a professional mentor for twelve months following registration in addition to the regular supervisory support she receives from her line manager. Mrs Jones should achieve the Registered Manager Award and training in the care of people with learning disabilities within one year of registration. 9th March 2006 3. 4. Date of last inspection Brief Description of the Service: Phillips House is a community home for people with learning disabilities, and is part of the Freeways Trust. The home is on three floors and is set in a residential area within easy access of the town centre, the sea front and local amenities. Most residents are in their forties or fifties. Phillips House DS0000008111.V311729.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out over two days, one in mid-December and one in late January, and both visits were unannounced. The inspector spent the first visit talking with residents and staff. She spoke in-depth with six of the residents, four of the staff, and with a visitor to the home. The inspector also separately consulted a professional who visits the home. The second visit involved talking with some of the staff on duty but was mainly spent doing a tour of the premises and sampling records, including: • residents contracts • care plans and other related records • staff rotas • complaints • staff training records • staff supervision dates • the minutes of residents and staff meetings. What the service does well: The staff team is very resident-focused, and residents have a lot of say in the running of the home. Residents said that they enjoy good relationships with all of the staff, and that staff always treat them with respect. Residents felt that they generally get on well with each other as a group: one person said the people here are my friends. A couple of peoples comments showed that staff intervene tactfully when there are disagreements, but do not try and take over. Residents felt that they get really good support to follow their own lifestyles. There are lots of interesting things to do, both in the way of work and leisure. Staff support people to plan and travel to a lot of activities, but individual residents felt very much in charge of deciding how they spend their time. Residents also get lots of opportunities to say what they think and to contribute their ideas to the way the home is run. There are regular residents meetings and, while staff often pass on information to the residents during these meetings, it is the residents who largely set the agenda. Meals and outings are regularly discussed in these meetings, as are the house rules. Wherever possible, residents are supported to be in charge of their own lives and make their own decisions. There is a good system of recording in place, and this is being well used. Phillips House DS0000008111.V311729.R02.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: There are many aspects to the safety of the premises that require urgent attention. Some of these are referred to in this report but this issue has been addressed in detail in a separate letter to the provider, who has been asked to provide an action plan for resolving them. Although the environment is generally homely and well-suited to the residents’ needs, there are several aspects which could be improved: • Several bedrooms are below 10 square metres. • There are 13 places registered, but the standard that comes into effect in April this year advises a maximum of 10 places as the optimum. • Staff at present use the attic lounge and the main downstairs lounge as sleeping-in rooms, rather than having dedicated rooms for this purpose. • At present there are no proper storage facilities for staff belongings. Life skills days are currently mainly used to support residents with their household chores. These days would be much more interesting for everyone if they were used for one-to-one support towards achieving care plan goals, such as learning to use community facilities more independently. Health Action Plans need to be expanded to cover a wider range of health care needs. Phillips House DS0000008111.V311729.R02.S.doc Version 5.2 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Phillips House DS0000008111.V311729.R02.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Phillips House DS0000008111.V311729.R02.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 4, 5 Quality in this outcome area is good. Residents get useful information about the home before deciding to move in. Their needs are thoroughly assessed, and a schedule of pre-admission visits is arranged to suit individual needs. Contracts are clear about residents rights, and are in a format likely to be accessible to them. EVIDENCE: The version of the service users guide in plain English, supported by pictures and symbols, has been revised. Each resident has had an updated copy at some point over the past year, which senior staff talked through with them. This guide gives useful and clear information. The Statement of Purpose has also been updated. Newer residents files included detailed pre-admission assessments carried out by the placing social workers. Prospective residents are encouraged to visit as often as necessary so that both they and the existing resident group can make an informed decision about whether or not to move in. The residents files seen all had a service-user-friendly contract. These documents were in plain English, supported by pictures and symbols. Staff had gone through the contracts with residents individually, and both they and the resident had signed a copy for the persons own file. The current range of fees is from £543.39 to £719.53. Phillips House DS0000008111.V311729.R02.S.doc Version 5.2 Page 10 Phillips House DS0000008111.V311729.R02.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9, 10 Quality in this outcome area is excellent . Residents needs are thoroughly assessed and documented, and staff keep this information securely. People are supported to make informed decisions and to exercise a lot of control over their lives. EVIDENCE: Residents individual files are in the process of being reorganized so that the information in them is easier to access. There is a really good depth of information kept on each persons needs and preferences. Three of the residents files were sampled in some depth, and each of these included a wealth of information about the persons preferred routines and lifestyle. Care plans are written increasingly from the residents’ point of view. Key workers write informative monthly summaries that show residents health care needs are regularly followed up, and that progress towards their chosen goals is monitored. These reports also include a monthly room check to ensure that the persons own environment is still meeting their needs. The inspector saw a number of examples of the many small ways in which staff have enabled residents to be more independent. For example, the videos of a Phillips House DS0000008111.V311729.R02.S.doc Version 5.2 Page 12 resident who cant read had been arranged on his shelves in groups - all the Bond movies together, all the thrillers together, and all the comedies in one pile - so that he could more easily find the video he wants to watch. Another person has her own kettle, mugs, and hot drinks supplies in her bedroom. Many of the younger residents have their own mobile phones. A couple of peoples care plans mentioned the need to stay in regular contact with their families, and some of the residents the inspector met confirmed that staff helped them to phone their families. Residents meetings are held regularly, and the minutes of these as well as residents comments to the inspector showed that they are able to air their views and are widely consulted. Many of the residents have their own copies of their contracts, Service User Guide, and care plans. Copies are also kept on file securely in the office. Phillips House DS0000008111.V311729.R02.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected 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 Quality in this outcome area is good. Each person has plenty of opportunities to broaden their experience and pursue their preferred lifestyle. EVIDENCE: Residents were enthusiastic about their work placements, and particularly about the social and leisure opportunities they enjoy. Some residents told the inspector about a planned visit to the Bristol hippodrome and to the local pantomime. Residents were also looking forward to the homes Christmas party, as well as to several local discos. Some residents are members of the Rangers, part of the Scouting movement, and have access to all sorts of interesting activities through this. Residents written timetables and their comments to the inspector showed that each person has a full and interesting range of activities. Many residents attend Freeway Trust’s own day centre at Leigh Court, but people also have opportunities to do courses at other community-based learning centres. Phillips House DS0000008111.V311729.R02.S.doc Version 5.2 Page 14 Each person has one day a week when they stay home for a life skills day. Key worker reports show that the support given on these days is mainly with household chores, such as changing bedlinen or doing laundry. Residents comments indicated that they also feel these days are for getting household chores done. A few reports showed that these days are being used more creatively, supporting residents to use community facilities independently. At present, whichever staff member is on duty on the resident’s life skills day gives support. This means that these days are not really planned. The inspector suggested that at least once a month the person’s key worker is rostered to work on their life skills day. Staff and resident could then plan that day together ahead of time, and make sure it is tailored to the individual person’s development needs, as described in their care plan. For example, one person might like support to use the local library independently, and to take advantage of the journey to brush up on road safety awareness. This will help residents make progress towards their care plan goals, and should make the life skills day far more enjoyable for both them and the staff. An aromatherapist visits the home regularly to offer residents aromatherapy massage. There are also plenty of in-house activities, including evenings where everyone has a take-away and enjoys a film, one-to-one cookery sessions, reflexology sessions, slimming club, barbecues, house parties and other visits from friends, and craft sessions. The interactions between staff and residents that the inspector saw supported residents comments about how respectfully staff treat them. Staff were warm and affectionate, used humour appropriately to deal with any potentially awkward situations, listened carefully to residents and showed a real interest in what they had to say. Residents and staff addressed each other as one adult to another. Residents relationships with each other, with other friends, and with their families are actively supported. Where difficulties arise or are anticipated, creative strategies are promptly put in place, and other carers involvement is sought. Residents told the inspector that the meals are very nice. Some people help the staff to prepare meals, and everybody is involved in planning the menus. Menu records show that residents tastes are catered for while providing balanced and nutritious meals. Phillips House DS0000008111.V311729.R02.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20, 21 Quality in this outcome area is good. Residents preferences are welldocumented and staff are familiar with these. Personal care needs are handled with tact. EVIDENCE: Each person has a Health Action Plan. These go into plenty of detail about issues such as opticians and dental checks, and also give good guidance about the persons particular health-care needs. However, routine health care checks - such as Well Man or Well Woman clinics, diabetes checks, breast checks and cervical smears - are not mentioned in these plans. There was a note on one residents file that breast screening has not been arranged for her because her next of kin does not wish her to have this. While relatives may be able to give useful information about residents preferences, they cannot actually give or withdraw consent to medical procedures on residents behalf. Where the person is able to make an informed decision on their own behalf, they should be supported to do so. If the resident is unable to do this, the decision needs to be made jointly by their carers. This might include relatives, the home’s staff, and the GP, who would be able to advise on the level of risk involved. Phillips House DS0000008111.V311729.R02.S.doc Version 5.2 Page 16 Discussion with residents and staff showed that staff are familiar with each persons needs and preferences, and that personal care is provided in a flexible and individualized way. The records of medications ordered and received in the home were checked and were up-to-date. The medication file includes a copy of the home’s medications policy and a note of the usual expiry dates of various types of medication. The records clearly show where individual residents retain responsibility for self-medication, and staff carry out a weekly check that this is still happening successfully. A record is kept of the yearly check of the first aid box contents. The District Nurse has visited to give any necessary support. The team gave excellent care to a resident who died recently, and work closely with external professionals. Other residents were kept appropriately informed about what was happening. A very difficult and traumatic situation was handled with great tact and care. Phillips House DS0000008111.V311729.R02.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Quality in this outcome area is excellent. Concerns are taken seriously, and appropriate action is being taken to protect residents. EVIDENCE: Freeways Trust has a comprehensive complaints procedure. The residents complaints procedure has been updated over the past year, and is now in plain English with symbols and pictures. Staff had gone through this procedure with residents individually, and both they and the resident had signed a copy for the residents own file. Due to the registered manager leaving, these procedures again need to be updated with the acting managers photograph. No complaints have been received by CSCI. The homes complaints file includes letters written by staff on residents behalf and signed by the resident where a person wishes to complain in writing but is unable to do so without this support. Complaints were mainly about other residents behaviour. The residents felt that they can talk to the staff, and that staff listen to them properly. All staff have abuse awareness training as part of their LDAF (Learning Disabilities Award Framework) qualification, and several staff have had additional abuse awareness training over the past year. It is planned in future that each staff member will have abuse awareness refresher training on a yearly basis. Freeways Trust has a clear and detailed whistle-blowing procedure. Phillips House DS0000008111.V311729.R02.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): 24, 25, 26, 27, 28, 30 Quality in this outcome area is adequate. The environment is pleasant and homely, and is generally well suited to residents needs. However, several bedrooms are very small and some aspects of the environments safety need to be urgently addressed. The present practice of staff using communal rooms for sleeping-in duties is not meeting residents needs to be able to use these rooms unrestricted nor does it promote staff privacy. EVIDENCE: The home overlooks a park and has lovely views across the town, at both front and back. There is a small and fairly secluded front garden, which has almost level access. There is a short flight of stairs down to the back garden from the dining room. This garden is also fairly secluded and has seating. Some bedrooms at the front of the house on the first floor lead out onto a small balcony. The inspector advised that the Trust ensures this is safe for use. There is a large and pleasant downstairs lounge, and an airy dining room that leads onto the kitchen. The large attic has also been made into a lounge for residents use. There is a bathroom and toilet on each floor. Most of the bathrooms have shower facilities. Phillips House DS0000008111.V311729.R02.S.doc Version 5.2 Page 19 The home is well maintained, nicely decorated and comfortably furnished. The lounge has been redecorated and looks lovely. Lots of the residents artwork is displayed in this room, and photographs of residents are displayed in the hall and dining room. Some of the residents made the homes Christmas decorations. All bedrooms are single. Three bedrooms and one bathroom with a walk-in shower are downstairs. Residents bedrooms were very individual and nicely untidy: people feel they can treat their bedrooms as their own space, and keep them in whatever state suits them best. According to the pre-inspection questionnaire submitted by the home, four of the residents bedrooms are below 10 m square. At present, only 11 people live in the home but it is at present registered for 13 people. The standard coming into effect in April this year is for a maximum of 10 people as the optimum. Freeways Trust intends looking at how aspects of the service could be tailored to more closely achieve this ideal. One resident is in a very small room but is about to move to a larger room. The inspector suggested that some of the other small bedrooms might be allocated different uses. For example, the very small bedroom by the office might make a useful one-to-one meeting room. This would allow people to have private conversations in a more peaceful environment than the main office, and should help to promote confidentiality within the home. Some of these undersized bedrooms might also be useful for staff sleeping-in accommodation. At present, staff sleep in the attic lounge and downstairs lounge. This is not a good arrangement as it may make residents feel they have to vacate these rooms as soon as staff go off duty at night. Staff must also have proper accommodation for sleeping-in duties, with lockable doors and somewhere safe to store their belongings. Some aspects of safety around the home require urgent attention. These issues have been the subject of a separate letter to the provider. The provider must submit an action plan to CSCI, including details of what work will be carried out within what timescales. One of these issues concerned window restrictors on windows above the ground floor. Many of the windows in rooms used by residents were unrestricted and, although several of them had bars fixed across, these were not positioned to prevent someone falling out. The Fire Officer must be consulted about suitable means of restricting these windows without blocking designated fire escape routes. The risk was reduced in the attic bathroom by the location of the window, and in some bedrooms by large pieces of furniture being placed in front of the windows. Some people may be at little risk and may actually prefer to be able to open their windows wide. If it is desirable for a window to open more than the amount recommended by the Environmental Health Officer, a written risk assessment needs to be compiled in each case. Phillips House DS0000008111.V311729.R02.S.doc Version 5.2 Page 20 Phillips House DS0000008111.V311729.R02.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35, 36 Quality in this outcome area is good. Staff are carefully selected, generally very well supported, and get an unusually wide range of training opportunities. EVIDENCE: Detailed job descriptions are available for each role. Conversation with staff showed that they are clear about what is expected of them. Staff rotas show that there are at least two staff on each shift. The manager are works one shift a week as part of the basic staffing levels but is mainly additional to these. Most days there is a third member of staff on duty. Two staff are on sleeping-in duty at night. A service-user-friendly version of the rota has been set up in the lounge, with photographs of the staff who will be on each shift. Unfortunately, this is not working as well as it might do, as one of the residents enjoys moving the photographs around. Those residents who are able to read have a copy of the weeks rota in their own rooms, and staff are evidently happy to answer residents’ queries about who is going to be on duty. It might be possible to give other residents their own copies of the photograph version of the rota, if a picture was taken with the digital camera and then put on the homes computer. Phillips House DS0000008111.V311729.R02.S.doc Version 5.2 Page 22 Freeways Trust staff are currently doing occasional shifts in other homes. This can help to cover staff shortages with staff who may be already known to the residents. It also helps to disseminate good practice and good ideas among the various homes within the Trust. The staff training records showed that each person has had well over the minimum amount of training required. Staff are offered an excellent range of interesting and relevant training courses. New staff do the LDAF (Learning Disabilities Award Framework) training, and are then put forward to do NVQs. At present, three of the nine care staff hold NVQ3, and two more staff are due to start NVQ three in the near future. One person also has CCETSW, and inservice course in social care. Staff supervision sessions had slipped over the summer, and most of the staff - including the homes acting manager - have not been having the level of formal support required. Two of the staff had only had two formal supervision sessions over the past year. However, all of the staff the inspector spoke with felt confident in their roles, were clear about what they should be working towards, and said that senior staff and members of the Freeways Trust management team are readily accessible to them. The acting manager and deputy, who do one-to-one supervision sessions with staff, have planned supervision dates for the next few months and staff are once again getting the necessary level of one-to-one support. Phillips House DS0000008111.V311729.R02.S.doc Version 5.2 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected 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 Quality in this outcome area is good. The home is being well run, and the acting manager is further developing its inclusive ethos. Residents views and interests are at the heart of decision-making, practice and policy. EVIDENCE: The registered manager left approximately 6 months ago, and her deputy has been appointed acting manager. She is about to apply to be registered. One of the support workers applied successfully to become deputy manager. Residents were able to tell the inspector what the house rules are, and confirmed that it was the resident group who drew these up. Staff described a supportive and relaxed working atmosphere. Individual staff told the inspector how they have been helped to build confidence and increase skills. Any concerns are aired openly, and people feel that the senior staff are responsive to peoples comments. Phillips House DS0000008111.V311729.R02.S.doc Version 5.2 Page 24 The minutes of residents and staff meetings showed that all sorts of issues are raised for discussion. Residents evidently have a lot of control over the agenda for their own meetings, and the minutes of these supported residents comments about how much say they have. Staff confirmed that they are invited to add items to the agenda for their meetings and felt that their comments and ideas are welcomed. Policies and procedures give clear and meaningful guidance, and are regularly reviewed. A working party, made up of Freeways service users and staff, has been looking at ways of making policies and procedures more person-centred and more accessible to service users. The most recent inspection report is displayed in the office. All nine of the care staff hold a current first aid certificate. Individual members of the Freeways senior management team regularly visit the home unannounced to carry out their own in-depth inspections. These visits involve a lot of time talking with residents and staff. This helps to keep line managers up-to-date with what is happening in the home, and residents and staff felt that they are highly accessible. Phillips House DS0000008111.V311729.R02.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 x 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 4 23 4 ENVIRONMENT Standard No Score 24 1 25 2 26 3 27 3 28 2 29 X 30 3 STAFFING Standard No Score 31 3 32 2 33 3 34 3 35 4 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 4 4 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 4 15 3 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 2 3 4 2 3 3 4 3 3 4 Phillips House DS0000008111.V311729.R02.S.doc Version 5.2 Page 26 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 YA18 Regulation 12 Requirement Where the person is able to make an informed decision about medical treatment on their own behalf, they should be supported to do so. If they are unable to do this, the decision needs to be made jointly by their carers. Health Action Plans need to include routine health checks. The Trust needs to check that they balcony at the front of the house is safe for residents use. An action plan must be submitted to the CSCI giving details of how the security issues around the home will be addressed and within what timescales. Staff must be provided with suitable storage facilities and sleeping accommodation. The Trust must draw up an action plan for addressing this. Timescale for action 23/01/07 2. 3. 4. YA19 YA24 YA24 12 23 23 23/03/07 23/02/07 12/02/07 5. YA28 23 23/02/07 Phillips House DS0000008111.V311729.R02.S.doc Version 5.2 Page 27 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. Refer to Standard YA11 YA24 YA25 Good Practice Recommendations The scope of life skills days should be widened to help residents achieve more of their life goals. A maximum of 10 people should be accommodated. An action plan should be drawn up regarding the bedrooms that are below 10 m square. Phillips House DS0000008111.V311729.R02.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 Phillips House DS0000008111.V311729.R02.S.doc Version 5.2 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!