Inspection on 09/05/06 for Proctor Residential Home Ltd

This inspection was carried out on 9th May 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 14 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Proctor Residential Home Ltd 11/11/08

Proctor Residential Home Ltd 16/10/07

Proctor Residential Home Ltd 28/11/06

Proctor Residential Home Ltd 20/01/06

Proctor Residential Home Ltd 27/09/05

Proctor Residential Home Ltd 12/01/05

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

CARE HOME ADULTS 18-65 Proctor Residential Home Ltd 40 Filton Avenue Horfield Bristol BS7 0AG Lead Inspector Sandra Jones Unannounced Inspection 9 May & 2nd June 2006 09:30 th Proctor Residential Home Ltd DS0000062466.V294379.R01.S.doc Version 5.1 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Proctor Residential Home Ltd DS0000062466.V294379.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Proctor Residential Home Ltd DS0000062466.V294379.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Proctor Residential Home Ltd Address 40 Filton Avenue Horfield Bristol BS7 0AG 0117 9354403 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) Proctor Residential Home Ltd Mr Michael Edward Kendall Care Home 5 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (5) of places Proctor Residential Home Ltd DS0000062466.V294379.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. May accommodate up to 5 persons, 2 of whom can be 65 years and over 20th January 2006 Date of last inspection Brief Description of the Service: Proctor House is a care home providing personal care for five service users aged between eighteen and sixty four years. The home is situated in a suburban area, and located on a bus route that gives access to local shops, leisure and other amenities. The home is in keeping with the local neighbourhood. The home has undergone re-registration with the Commission for Social Care Inspection as the business has moved from a sole trader to a limited company. In addition the manager of the home has changed from Mrs Kendall to Mr Kendall (the son). Mrs Kendall remains the provider. The home primarily provides personal care to service users with a mental disorder. It is a quiet home that would best be suited to those who prefer a quieter lifestyle. Fees range from £1212.00 - £1994.32 per fortnight. Proctor Residential Home Ltd DS0000062466.V294379.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was conducted over two days. The initial date of the inspection was on the 9/05/06 and the second occurred on the 2/06/06. The date of the second inspection was to ensure the manager would be available to discuss the day-to-day management of the home. The inspection was based on the assessments of key standards through the evaluation of records and discussions with staff and residents. Resident surveys were sent to the home in advance of the inspection and full responses were received. Feedback from the member of staff on duty was sought on the conduct of the home and from two residents on the standards of care. What the service does well: What has improved since the last inspection? Since the last inspection, a conservatory was erected. This space is used as a designated smoking area, which will also provide an area for residents to make refreshments and light snacks. This is a positive response to offering residents more choice about their meals and alternate communal space. The manager continues to develop systems that will promote the standards of care at the home. Proctor Residential Home Ltd DS0000062466.V294379.R01.S.doc Version 5.1 Page 6 The recruitment of staff to cover senior roles will increase the staffing levels at the home and reduce the number of hours worked by the service provider and manager. 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. Proctor Residential Home Ltd DS0000062466.V294379.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Proctor Residential Home Ltd DS0000062466.V294379.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is adequate. The manager will provide residents with information so that they can make decisions about living at the home. Contracts must have the person’s room number and information about the annual review of the fees. EVIDENCE: Two admissions have occurred to the home since June 2005. Both admissions were referrals from Local Authorities and the care manager provided core and risk assessments. Members of staff with the resident complete initial assessments during admission to the home. Both the residents admitted are under Sections of the Mental Health Act. Service users surveys were sent to the home and all the residents responded. The current residents indicated that they were enabled to make decisions about living at the home. With the exception of one person, information about the home was provided to all the residents. Copies of signed contracts are kept in the individuals case records. The arrangements for admission including trial periods, absences and the payment fees are described. The routines and rules for both parties are incorporated within the contract. Information about review of fees must be detailed along Proctor Residential Home Ltd DS0000062466.V294379.R01.S.doc Version 5.1 Page 9 with the individuals room number to make the contract meaningful. One resident made additional comments through the survey that there were opportunities to visit the home before admission. Proctor Residential Home Ltd DS0000062466.V294379.R01.S.doc Version 5.1 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 in this outcome area is poor. Care plans must be developed from the Individual Care Planning approach meetings and information sought through home’s assessments. For residents under section, care plans must define actions to be taken for breaches of conditions. Residents report that they are able to make decisions about their lives. Risk assessments must be further developed to ensure the actions taken reflect the level of risk. EVIDENCE: The care coordinator convenes care-planning reviews annually for two residents. For the other three residents Individual Care Planning Approach (ICPA) meetings take place more regularly. Generally people involved in the care of the person and next of kin are invited to the review meeting with the resident, if appropriate. Proctor Residential Home Ltd DS0000062466.V294379.R01.S.doc Version 5.1 Page 11 Service user plans completed by staff and the residents are in place. The plans are based on routines, likes and dislikes for meals, personal hygiene and social needs. General health, community access and relationships are also included within the format. It is a tick box system with additional space for comments and brief descriptions. Strategies, risk assessments are in place for inappropriate, aggressive and violent behaviours. Reactive strategies were developed for two residents that at times exhibit aggressive, violent and inappropriate behaviours. The guidance although clear for staff, must be dated on review. Care plans that draw information from ICPA’s, initial assessments and risk assessments are not currently in place. The manager must devise care plans that provide action plans for staff to follow. The residents must be part of the process and their preferred routines, likes and dislikes must be incorporated. For residents subject to section under the Mental Health Act, care plans must guide staff on the actions to be taken whenever breaches of the conditions occur. Residents are able to verbally communicate their wishes to the staff. It is evident from the daily reports that residents make choices about the times medication is administered, retiring and daily activities. Residents wishes are discussed during review meetings and their comments are included in their ICPA. Through the surveys, two residents indicated that they always make decisions about what they do each day, two stated that it is usual for them to make decisions and sometimes, for one person. Once the care planning process is developed the residents abilities to make decisions will be clarified and better evidenced. Risk assessments are in place for one resident that staff administer insulin. While the risk assessments clearly details the risk identified, the measures to reduce the risk are not included. Risk assessments must detail the risk, the options available with the actions to reduce the level of risk. Risk assessments must be completed for one resident who will destroy official documents because staff therefore open any mail addressed to this person. Proctor Residential Home Ltd DS0000062466.V294379.R01.S.doc Version 5.1 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 in this outcome area is adequate. Residents aspirations and personal developmental goals must form part of the care planning process. Residents confirmed that they can leave the home without support from staff and are part of the community. Residents have a clear understanding of the rules and routines of the home. Residents are satisfied with the quality of the meals. A record of cooked meats and a better record of the food provided must be maintained. EVIDENCE: Proctor Residential Home Ltd DS0000062466.V294379.R01.S.doc Version 5.1 Page 13 The manager seeks residents feedback on their interests, leisure activities and goals. While feedback is sought from residents, care plans do not include social and personal development needs. Care plans must be include residents leisure activities, aspirations and goals. Action plans must be developed to ensure all aspects of the individuals lifestyle are recognised and considered. There is a rota of possible outings and each week a designated member of staff will discuss with residents, their leisure activities preferences. This member of staff will discuss with the residents the week’s activity or suggest possible activities. It was understood from this person that consultation takes place at the beginning of the week and the activity will then occur midweek. There is a record of the outing in the individuals reports of significance. Residents do not currently attend structured daytime activities or employment. Through the surveys, residents indicated that they are able to arrange their day and weekends. Two residents agreed to give feedback during the inspection. Both residents described their daily routines and their interests. Residents generally read, watch the television and visit the local shops. Residents consulted confirmed that they are able to leave the home without staff support. The service provider reported that three residents are registered onto the electoral roll. The other two residents must reside in the local community for a specific period before they can register. The arrangements for visiting at the home are included within the contracts. Friends and family are welcome at the home. There is a visitors book and visitors to the home must record the date, time and purpose of their visit to the home. The two residents giving feedback reported that they had no visitors to the home. Records indicate that two residents have visitors. Terms and conditions of residency list the rules and expectations of both parties. It was understood from the service provider that there is an expectation that residents keep their rooms tidy, clear their dishes and put their laundry in the basket. Two residents consulted during the inspection stated that the staff undertake all chores and household tasks. Bedrooms are lockable and residents are provided with keys to their bedrooms. Residents stated during the inspection and through surveys that they are treated well by the staff and act upon what they say. A member of staff on duty stated that there is sufficient time during the day to sit and chat with residents. Smoking is permitted in the conservatory only and residents are restricted from using the kitchen. The Statement of Purpose is clear about access to the Proctor Residential Home Ltd DS0000062466.V294379.R01.S.doc Version 5.1 Page 14 kitchen, it is kept locked whenever staff are not in the catering area. A conservatory was recently erected for residents to smoke and to make refreshments. It is the intention to provide a fridge and kettle for residents to make refreshments and light snacks. This will provide additional space, as residents do not have access to the home’s kitchen. Two residents giving feedback during the inspection reported that the meals served are good and sufficient in quantity. In terms of choices of meals the residents confirmed that the meals served are always liked because the manager is aware of their taste. The record of food provided is inadequate as the breakfast and teatime meals are not recorded. Additionally the record does not support that residents choose the meals to be prepared. The record of food provided must be more detailed and must include breakfast, lunch and teatime meals. The range of frozen, canned and fresh foods indicate that residents have varied and nutritious meals. There is a record of freezer and fridge temperatures. However a record of cooked meat is not currently maintained. Proctor Residential Home Ltd DS0000062466.V294379.R01.S.doc Version 5.1 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 Quality in this outcome area is adequate. Residents manage their personal support need with some prompting from the staff. Residents’ health care needs are monitored by the staff and where appropriate referred for specialist support. The practice of dispensing medications into individual pots for staff to administer at a later date must cease. EVIDENCE: Overall the currently accommodated residents can manage their personal care needs. Staff will prompt residents with personal hygiene. Residents consulted during the inspection confirmed that they are independent with personal care and are not assisted by the staff. One resident has some continence needs which are managed without outside intervention. One resident will be referred to a physiotherapist in future. Three residents have diabetes, two are controlled by medication and one is controlled by insulin. For the resident that is a insulin controlled diabetic, the manager and service provider administer the daily dose, for which competency was achieved through training. Proctor Residential Home Ltd DS0000062466.V294379.R01.S.doc Version 5.1 Page 16 The residents have full access to NHS facilities, visits from the optician are arranged to the home and residents visit the local dentist regularly. The staff accompany residents on outpatients appointments and GP’s visits. Residents have input from a psychiatrist, for some there are annual visits and for others these visits are more regular. At the time of the inspection, a Community Forensic Nurse (CFN) was visiting a resident and feedback was sought from this person. Positive comments about observations of the standards of care were made. It was reported that staff are always on duty to convey information. The environment is clean and there is additional space other than bedrooms to have a private discussion with the person. Additional comments made related to the manager and service provider attending Individual Care Planning Approach (ICPA) meetings and their clear understanding of the needs of the residents. There is sufficient information within residents’ case records from outside professionals to monitor residents’ health and to recognise complications for referrals to appropriate specialists. Four residents have regular prescribed medication administered through a monitored dosage system. One resident self medicates and the CFN monitors the individual’s administration. A record of medications no longer required is maintained, which is countersigned by the pharmacist to evidence receipt of the medication for disposal. It was revealed during the inspection that in the evenings the service provider removes the medications from the monitored dosage system. The medications are then placed into individual pots for staff to administer at a later time. The service provider will then sign the record. This practice must cease and members of staff must administer the medication directly from the system. This current system is open to errors and is confusing. It was explained by the manager that members of staff receive training from the local pharmacist about the medications, ordering and administration of medication. The manager must ensure competency of the staff by observing and shadowing the staff before they administer medications unsupervised. Proctor Residential Home Ltd DS0000062466.V294379.R01.S.doc Version 5.1 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 adequate. Residents are clear about the procedure for making complaints and will approach the manager and service provider. The manager and staff must attend POVA training and in-house policies must reflect current good practice guidance. EVIDENCE: There were no complaints received at the home or CSCI from residents for investigation since the last inspection. Residents meetings are other forums used by residents to raise complaints. The records of residents meetings indicate that areas of concern are discussed at these meetings. Residents consulted at the inspection confirmed that the service provider and manager would be approached with complaints. Through surveys residents responded that they are aware of the procedure for making complaints and know who to approach. The “No Secrets” guidance is available at the home with the home’s Protection of Vulnerable Adults policy. The home’s policy must be reviewed to reflect current good practice guidelines. It was understood from the manager that one member of staff has attended external POVA training. This individual was clear about the principles of abuse and the procedure for reporting poor practice. The manager and service provider have not attended any POVA training. It is therefore required that the manager attend external POVA training for managers and providers. Members of staff must attend POVA training to promote the safety of the residents at the home. Proctor Residential Home Ltd DS0000062466.V294379.R01.S.doc Version 5.1 Page 18 Proctor Residential Home Ltd DS0000062466.V294379.R01.S.doc Version 5.1 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 26,27,28 & 30 Quality in this outcome area is adequate. The property is homely and maintained to a reasonable standard but the manager must attend to the repairs highlighted. Bedrooms have suitable furniture and fittings for the person to maintain their chosen lifestyle. There are sufficient toilets and bathrooms for the number of residents accommodated. The shared space provided sufficient space for group activities and private space. The home is clean and free from unpleasant smells. EVIDENCE: Proctor House is a terrace property in a residential environment. It has the appearance of a domestic dwelling arranged over three floors. The ground and first floor are used by residents and have bedrooms and shared space on each floor. The property is close to shops, amenities and bus route, which are used regularly by the residents. Proctor Residential Home Ltd DS0000062466.V294379.R01.S.doc Version 5.1 Page 20 There are a number of minor repairs noted that require attention. The carpet in room 3 and dining room are in need of cleaning. The tiles in the downstairs shower cubicle are in need of re-grouting. Bedrooms are single and the opportunity was taken to view a number of bedrooms. It was noted that bedrooms are lockable and residents have a lockable facility in their rooms. There is a hand washbasin, adequate floor covering, nurse calls and a radiator in each room. The furniture and fittings are provided by the home and personal belongings reflect the person’s personality. A full bathroom is located on the first floor and a shower and toilet on the ground floor. The ratio of bathrooms and toilets are less that three people sharing the two bathrooms. This is above the National Minimum Standards of three people sharing. There is a sitting/dining room, conservatory and visitors’ room. The combined seating and dining room has seating for four people and dining space for four people. The conservatory is used as a designated smoking area with additional facilities for making light snacks and refreshments in the future. The visitor’s room is accessible to residents and used for private visits. The laundry area is adjacent to the kitchen and has the washing machine and a locked COSHH cabinet. The floor covering and painted walls ensures easy cleaning. The washing machine is domestic and has can reach 95degrees C. Proctor Residential Home Ltd DS0000062466.V294379.R01.S.doc Version 5.1 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): 33,34 &35 Quality in this outcome area is poor. The recruitment of two additional staff will develop the efficiency of the home. The recruitment process must be more robust in terms of the information sought through the application form. Members of staff must attend statutory training and Mental Health Awareness training to provide insight into the needs of the residents accommodated. EVIDENCE: The rota in place suggests that one member of staff is on duty throughout the day with the service provider and manager. From 4:00pm until 8:00pm staffing levels increase to two staff. One person sleeps on the premises at night and ancillary staff are employed twice weekly. It is apparent from the rota that the service provider and manager are rostered to work over 80 hours per week. It is the intention of the manager to recruit two people from overseas for the position of senior carers. This will improve the staffing levels and decrease the number of hours worked by the service provider and manager. Proctor Residential Home Ltd DS0000062466.V294379.R01.S.doc Version 5.1 Page 22 Six staff are currently employed at the home. Completed application forms were in place for two staff and two have written references. CRB disclosures were obtained for all staff that are employed at the home. Application forms must be updated to seek full employment histories with reasons for leaving. Members of staff must provide through the application form the names of two referees. While a copy of the General Social Care Council (GSCC) Code of Practice is available at the home, staff are not provided with their own copy. The manager must provide staff with a copy of the GSCC Code of Practice and staff must sign to indicate receipt and their understanding of the code. Members of staff receive a basic induction programme that entails familiarisation of the building and information about the needs of the residents. It was understood from the manager that a formal record of the induction programme is not currently kept. All newly employed staff must complete an induction programme that covers in-house training and follows Sector Skills Council specification. One member of staff currently has up to date statutory training, which includes Food Hygiene, First Aid and Manual Handling. Other specific training has been undertaken by this person and four people have attended medication training from the local pharmacist. One person has attended Mental Health Awareness training in 2005. One member of staff on duty during the inspection commented that training is accessible. The manager will generally discuss training available and suggest appropriate training. The manager must ensure that staff attend the statutory training and Mental Health Awareness training in order to gain insight into the needs of the residents accommodated. Proctor Residential Home Ltd DS0000062466.V294379.R01.S.doc Version 5.1 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): 38 &42 Quality in this outcome area is adequate. There is a “family” ethos at the home. The manager has taken steps to maintain the environment within associated legislation. Two members of staff must attend fire drills and fire training. EVIDENCE: Since the last inspection, the manager has designed the recently erected conservatory to offer more choice to residents. Office systems are more streamlined and more staff are to be recruited. Residents consulted through surveys and the inspection, were positive about the staff’s capabilities. The member of staff on duty confirmed that records are available and information is accessible. This individual commented that there is a family atmosphere in the home. Proctor Residential Home Ltd DS0000062466.V294379.R01.S.doc Version 5.1 Page 24 The home maintains an accident book for residents and staff. The records that relate to fire safety checks and practices were examined. Fire Safety training and drills are provided and two staff have not attended the training within the recommended frequencies. Records of checks conducted by the staff and contractors are up to date. The manager takes steps to comply with associated legislation by the checks of system and appliances. Competent contractors are engaged, to check the gas boiler and electrical appliances annually at the home. The Local Authority funds the residents currently accommodated and the fees are paid directly into the home’s account. Fees range from £1212.00 £1994.32 per fortnight. Two residents manage their own finances and the service provider is the appointee for three people. For residents that the service provider acts as appointee, a record of personal allowances handed to them is kept. Within the record is a statement regarding the arrangements for personal allowance and Disability Living Allowance (DLA). The record is signed by the person to indicate receipt of their personal allowance and DLA if it is paid to the person. Proctor Residential Home Ltd DS0000062466.V294379.R01.S.doc Version 5.1 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 x 2 2 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 2 25 x 26 3 27 3 28 3 29 x 30 3 STAFFING Standard No Score 31 x 32 x 33 3 34 2 35 1 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 1 2 x 1 x LIFESTYLES Standard No Score 11 x 12 2 13 3 14 3 15 3 16 3 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 1 x 3 x 3 x x 2 x Proctor Residential Home Ltd DS0000062466.V294379.R01.S.doc Version 5.1 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 2 Standard YA42 YA35 Regulation 23(4) 18(1)(c) Requirement Members of staff must attend fire drills and training at the stipulated frequencies. All newly employed staff must complete an induction programme that covers in-house training and follows Sector Skills Council specification. Members of staff must receive a copy of the GSCC Code of Practice for which they must sign to indicate receipt and their understanding. Members of staff must attend statutory training and mental health awareness training. The recruitment process must be more robust in terms of the information sought through the application form. Full employment histories with reasons for leaving past employment and the names of two referees must be sought. The carpets in the dining room and room 3 must be cleaned. The tiles in the downstairs shower must be re-grouted. Timescale for action 30/09/06 30/10/06 3 YA23 18(4) 30/08/06 4 5 YA35 YA34 18(1)(c) 19 30/12/06 30/08/06 6 YA24 23(2)(b) 30/07/06 Proctor Residential Home Ltd DS0000062466.V294379.R01.S.doc Version 5.1 Page 27 7 YA23 13(6) 8 YA17 17(2) Sch 4.13 16 The manager must attend POVA 30/12/06 training for managers and staff must attend the alerts course. In-house policies for protecting residents must reflect current good practice. The Home to record the food 30/07/06 eaten by the residents. A record of cooked meat must be kept. (Previously required 20/01/06) Contracts for residents must include the room number and information about the annual review of the fees. The service provider must ensure staff’s competency to administer medications before administering medications unsupervised. Medications must not be dispensed into pots for staff to administer at a later date Ensure staff receive formal supervision. (Previously required 20/01/06) The manager and proprietor to ensure they have refresher statutory training of first aid, manual handling and food hygiene 30/07/06 9 YA5 5 10 YA20 13(2) 30/07/06 11 YA36 18(1)(a) 09/05/06 12 YA35 18(1)(a) 30/07/06 13 YA6 15 14 YA9 13(4)(b) Care plans must be developed 30/09/06 using the information gathered from the home and ICPA. The individuals likes, dislikes and preferred routines must be included, along with their aspirations and personal development goals. For residents under section the action plans must define the actions to be taken for any breaches of conditions. Risk assessments must detail the 30/08/06 measures to be taken to reduce the level of risk. DS0000062466.V294379.R01.S.doc Version 5.1 Page 28 Proctor Residential Home Ltd RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Proctor Residential Home Ltd DS0000062466.V294379.R01.S.doc Version 5.1 Page 29 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG 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 Proctor Residential Home Ltd DS0000062466.V294379.R01.S.doc Version 5.1 Page 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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