Inspection on 30/11/06 for Prospect Hill (12)

This inspection was carried out on 30th November 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 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

The Cornerstone

John Street Nursing Home

Pennine Camphill

Whitwood House

Whitwood Hall

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

CARE HOME ADULTS 18-65 Prospect Hill (12) 12 Prospect Hill Whitby North Yorkshire YO21 1QE Lead Inspector Mr Tom Tomlinson Key Unannounced Inspection 30th November 2006 09:30 Prospect Hill (12) DS0000067654.V319022.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 Prospect Hill (12) DS0000067654.V319022.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. Prospect Hill (12) DS0000067654.V319022.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Prospect Hill (12) Address 12 Prospect Hill Whitby North Yorkshire YO21 1QE 01947 604606 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) Prospect Care Limited Mrs Audrey Mary Boyes Care Home 8 Category(ies) of Learning disability (8), Learning disability over registration, with number 65 years of age (8) of places Prospect Hill (12) DS0000067654.V319022.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 07/02/06 Brief Description of the Service: 12 Prospect Hill is a Victorian mid-terraced property situated in a residential area of Whitby. It is conveniently located for all of the main community facilities including the public transport network. The property has parking for several vehicles at the rear. The property has four floors with the service users accommodation being located on the ground and upper floors. The lounge, dining area, kitchen and laundry are situated on the lower ground floor. The property can be access by either the ground or lower ground floor. The property does not have a passenger lift and consequently it is only considered suitable for use by service users who are fully ambulant. Prospect Hill provides accommodation and personal care for a maximum of eight service users who have a learning disability. The staff does not provide nursing care. Should such care be required on a short-term basis then the community healthcare resources will provide it. Prospect Hill (12) DS0000067654.V319022.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection visit forms part of the annual key inspection process for 12 Prospect Hill. The visit took approximately five and a half hours. Discussions were held with the more able service users, the staff on duty and the registered manager. Reliance was placed on the observation of those service users who had limited verbal communication skills. Comment Cards were received from two social care professionals. An inspection of the premises was undertaken. A number of statutory records were examined. Feedback was provided for the registered manager at the conclusion of the inspection visit. This report also incorporates information received by the Commission for Social Care Inspection prior to the inspection visit. The current fees for the service users go from £400 upwards. The fee is negotiated with the placing authority and is based on the needs of the service user concerned. What the service does well: What has improved since the last inspection? Progress continues to be made regarding staff training. Approximately 70 of the staff now have a National Vocational Qualification at level 2 or above. Since the last inspection the registered manager has commenced the Registered manager’s Award. The manager and staff have continued to look at ways of developing the service users’ life skills and have improved the range of social activities available to them. Prospect Hill (12) DS0000067654.V319022.R01.S.doc Version 5.2 Page 6 The most obvious improvement is to the physical standard of the property. This has involved additional bathing facilities, a new laundry room and a refurbished kitchen and dining area. 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. The summary of this inspection report can be made available in other formats on request. Prospect Hill (12) DS0000067654.V319022.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 Prospect Hill (12) DS0000067654.V319022.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. JUDGEMENT – we looked at outcomes for the following standard(s): 2. Quality in this outcome area is good. A sound pre-admission assessment process is in place that should ensure that a prospective placement is appropriate and that the staff are able to meet the assessed needs of the service user concerned. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Whilst there had been no service user admissions since 2003, from the records maintained it was evident that a sound pre-admission assessment process was in place. This ensured that adequate information was obtained on a prospective service user so that the registered manager could make a considered decision as to the appropriateness of a proposed placement. According to the registered manager this process was followed regardless at to whether a placing authority was involved. The admission process involved, where possible, a ‘phased’ introduction for a new service user so that they could meet the existing service users and become adjusted to their new environment. This process helped lessen the amount of stress possibly experienced by a new service user. Prospect Hill (12) DS0000067654.V319022.R01.S.doc Version 5.2 Page 9 Five of the service users had been admitted from long-term care hospitals in 1991 as part of the Community Care process and consequently their original assessments were not available. The manager placed considerable emphasis on the admission and assessment process to ensure that the home was capable of meeting the needs of a prospective service user and that the service user was compatible with the existing service users. Four of the eight current service users had limited verbal communication skills and consequently were unable to confirm the admission process. The other service users confirmed that they had been directly involved in the process. Prospect Hill (12) DS0000067654.V319022.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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9. Quality in this outcome area is good. The service users are provided with care plans that form the basis of good care and ensure that all of their assessed needs are met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All of the service users had a care plan developed by the home. This was in addition to care plans provided by a placing authority. The care plans were reasonably comprehensive and were ‘tailored’ to individual service users. They identified the primary needs of the service users and the actions to be taken by the staff in order to meet those needs. Five of the service users had been assessed as not being capable of having direct involvement in, or oversight of, their care plans. The other more able service users were aware of the records maintained on them and knew where they were kept but expressed no interest in reading them. Prospect Hill (12) DS0000067654.V319022.R01.S.doc Version 5.2 Page 11 There was recorded evidence that the care plans had been regularly reviewed by the home’s manager and amended as necessary. According to the manager the respective service user had been involved in the review if they wished but none made any particular contribution. There was recorded evidence that where possible the views of the service users’ relatives had been sought and incorporated into the reviews. The home uses a ‘key worker’ system for monitoring the needs and wishes of the service users. Whilst the key workers demonstrated an excellent understanding of the service users, they were not directly involved in the care planning or review process. The service users presented as having a diverse range of needs. This ranged from service users who required considerable input and support from the staff to those who were reasonably independent and required minimal support. According to the pre-inspection questionnaire submitted by the registered manager, four service users had limited verbal communication skills and one required the assistance of two staff during the day and night. Several were the subjects of toileting programmes. It was observed that these were implemented in a discreet way so not to undermine the dignity of the service user concerned. There was no physical evidence of incontinence problems. It was observed that the staff actively promoted the service users’ independence. In some cases this consisted of relatively minor actions such as going to the toilet unaided or putting on their coat. It was observed that the staff did not ‘fuss’ over the service users but allowed them to function at their own pace. The staff invariably encouraged the service users to answer questions for themselves. The level of independence was in relation to the ability level and understanding of the service user concerned. All of the service users had been risk assessed and strategies were in place to minimise any risk. By this action the home had achieved a reasonable balance between safety and promoting the service users’ independence. Prospect Hill (12) DS0000067654.V319022.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. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16 and 17. Quality in this outcome area is good. The service users are provided with a range of social activities both within and outside of the home as an integral part of their life skills training. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The care records provided confirmation that the service users lead reasonably active social lives and had good levels of contact with the local community including the immediate neighbours. The more able service users confirmed that they often go out and that they had been for a caravan holiday during the summer. There was not a set programme of social activities but these were planned to take into account the wishes of the service users at any particular time. Several of the service users attended local organisations and one had been allocated a support worker by the local social services. On the day of the inspection this service user was going into the local town shopping. There was Prospect Hill (12) DS0000067654.V319022.R01.S.doc Version 5.2 Page 13 recorded evidence that good contact had been maintained with the relatives of the majority of the service users. The home presented as being a normal domestic environment in which the service users could lead their lives at their own pace. One of the service users saw himself as being a member of staff and had established a degree of responsibility for seeing that certain things were done. He particularly enjoyed assisting a less able service user who he had known for many years. In response to questions he replied, “I’m alright – I’ve got a new desk – have you seen my office?” and another said, “I’m quite happy. I’m still getting out a lot and my niece from …… is going to visit me”. Two other service users confirmed that they enjoyed going to the local pub for a drink. It was reassuring that the inspector was initially welcomed by a service user at the main entrance to the care home. The home did not have its own transport but shared a vehicle with the registered provider’s other home in Robin Hoods Bay. One member of staff felt that having transport readily available would provide the service users with a greater range of social opportunities. To an extent the frequency of social activities, particularly on an individual basis outside of the home, was dependent up on the availability of staff. From observation of the staff and service users it was apparent that a close but professional relationship existed. The service users responded well to the staff and were not reticent in asking for assistance. The staff provided assistance for the service users with patience and understanding. They gave them respect by speaking to them in an adult manner, by including them in general conversations and by gaining their permission before entering their bedroom. When staff needed to be directive or firm with a service user it was done in a respectful manner so not to embarrass the service user concerned. The menus indicated that the meals were varied and nutritional. The meals were prepared and cooked by the staff with the assistance of some of the service users. One member of staff had considerable experience working in the catering industry and consequently had good knowledge of food preparation. The main meal of the day was generally eaten in the evening during the week to take into account the service users activities and appointments. The mealtimes were reasonably flexible. A service user who was having breakfast at the start of the inspection confirmed this. As part of the nutritional monitoring process the service users had been regularly weighed. Prospect Hill (12) DS0000067654.V319022.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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this outcome area is excellent. The personal and health care needs of the service users are well met through excellent support from the staff and good levels of input from health and social care professionals. This judgement has been made using available evidence including a visit to this service. EVIDENCE: It was evident from the care records that the support provided for the service users had been tailored to meet individual’s needs and wishes. This meant that the service users were treated as individuals and not purely as a service user group. The provision of the high standard of care depended upon a close relationship having been established between the staff and the service users. This was particularly important for four of the service users who had limited verbal communication skills. It was apparent that the service users were relaxed and felt at home in their environment. This provided them with a degree of ownership over it. They appeared to relate to the staff as equals and were not reticent in voicing their views. Prospect Hill (12) DS0000067654.V319022.R01.S.doc Version 5.2 Page 15 The staff not only demonstrated a good understanding of the service users’ needs but also had insight into behaviour problems and personal idiosyncrasies. For example, one service user presented as being very capable but it was evident from discussions with the staff and observation of the service user that he required considerable support and guidance. It became apparent that he would repeat phrases that sounded impressive. This service user also did not like physical contact and would often display his frustration through behaviour. This was fully recorded but more importantly the staff knew how to address this service user’s needs and behaviour to ensure that he remained socially acceptable. The records confirmed that the service users had been provided with excellent healthcare support and had all been registered with the local medical practice. Advice had been sought by the registered manager regarding service users’ general health and in particularly speech and dietary problems. One service user had epilepsy that was generally controlled through the use of medication. A record was maintained of this person’s seizures to assist healthcare professionals in minimising the frequency and effect of the seizures. The home continued to use a monitored dosage system for the administration of the bulk of the service users’ medication. Those staff responsible for the administration process had been appropriately trained. The medication was appropriately secured. Arrangements were in place for the use of controlled drugs although none were in use at the time of the inspection visit. A member of staff described the administration process. It was evident that it was efficient and minimised the chance of error. The medication records were complete and up to date. None of the service users were assessed as being capable of safely self-administering their medication. Prospect Hill (12) DS0000067654.V319022.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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is good. The network of internal and external support provided for the service users should ensure that their welfare and safety is appropriately safeguarded. This judgement has been made using available evidence including a visit to this service. EVIDENCE: An appropriate complaints procedure was in place. This procedure was displayed and was therefore readily available to visitors to the home. The majority of the service users had no, or very limited, literacy skills and consequently relied on others to make formal complaints on their behalf. In this sense the staff, particularly the key workers, operated in an advocacy role for the service users. Arrangements were in place for service users to use alternative forms of communication, such as a pictorial format, in order to make their view and, if necessary, complaints known. The staff acknowledged that this approach had its limitations. From discussions with the staff it was evident that they would not hesitate to complain on behalf of a service user. The registered manager said that the use of independent advocates has been considered but that it had proved difficult particularly for those service users who had limited verbal communication skills and/or a behavioural problem as the advocate would require specialist skills. All of the staff had received training on Adult Protection procedures that included the types and indications of abuse. The staff demonstrated a sound Prospect Hill (12) DS0000067654.V319022.R01.S.doc Version 5.2 Page 17 understanding regarding the action they should take should allegations (or indications) of abuse, be made. From the information and evidence available it was concluded that the internal and external network of support for the service users should ensure that any concern or malpractice would be quickly identified and acted upon. Prospect Hill (12) DS0000067654.V319022.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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28 and 30. Quality in this outcome area is good. The premises provide the service users with a pleasant and comfortable place in which to live. The design of the property, and the lack of a passenger lift, limits the access of the less able service users to all floors of the property. This judgement has been made using available evidence including a visit to this service. EVIDENCE: To the visitor the care home presented as a normal domestic environment in which the service users could lead their lives at their own pace. It was warm, clean and totally free from any offensive odours. As identified in the previous inspection report a major programme refurbishment had been undertaken. This had resulted in redesigned kitchen and dining areas and the provision of bathing and toileting facilities on each floor of the property. A dedicated laundry area had also been added. The double-glazing considerably reduced the noise of traffic at the front of the Prospect Hill (12) DS0000067654.V319022.R01.S.doc Version 5.2 Page 19 property. This refurbishment had been primarily provided for the benefit of the service users and had the effect of further promoting their privacy, dignity and safety. The communal areas on the lower ground floor were furnished and decorated to a good standard. This further enhanced the domesticity of the care home. The service users’ rooms were decorated to a high standard. The service users had been encouraged to furnish their rooms with their personal belongings and consequently the rooms tended to reflect the character and gender of the occupant of the room. One bedroom was shared. The two occupants had, however, shared for a considerable number of years and in the opinion of the registered manager it would be inappropriate to separate them as it could cause them high levels of anxiety. The two service users concerned were, due to their disabilities, unable to give an opinion. For identification purposes the service users had their names on their bedroom doors. Whilst the majority of the service users had unrestricted access to all floors of the property, it had been considered necessary by the manager to have a ‘safety-gate’ fitted on the lower ground floor to restrict access to the stairs by one service user who had mobility problems. It was observed that the more able service users could operate this safety gate. The use of this safety-gate had been formally risk assessed and its use had been regularly reviewed. To an extent the use of the safety-gate had been deemed necessary by the fact that the home did not have a passenger lift. According to the registered manager the Registered Provider had considered having a lift installed but due to the design of the property this had not proved possible. Consequently this has meant that the less able service users had to be supervised and assisted when using the stairs. The property had good levels of toileting and bathing facilities. Having such facilities on each floor of the property ensured that the service users had ready access to them. The hot water outlets had control valves fitted to maintain the temperature of the water within safe limits. The temperature of the hot water had been regularly checked and recorded. It was evident that the more able service users had unrestricted access to their rooms and presented as having considerable pride in their accommodation. The property had a rear garden area that was accessible to the service users. As far as could be ascertained from the home’s records, the premises satisfied the specific requirements of the Fire and Environmental health departments. Prospect Hill (12) DS0000067654.V319022.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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 and 36. Quality in this outcome area is good. The service users are support by a competent and experienced staff team who, despite the limitations imposed by the number of staff available, enable the service users to lead meaningful lives. This judgement has been made using available evidence including a visit to this service. EVIDENCE: From discussions with the registered manager and an examination of the staff roster, it was apparent that the normal day staffing level consisted of two support workers plus the registered manager. Whilst this, according to the staff, was appropriate to provide normal levels of care for the service users, it did not always take into account any unplanned activities/incidents such as the sudden illness of a service user. This was further exacerbated by the fact that at least one service user required the assistance of two staff during the day and night and three others were assessed as having specific care needs, one had regular epileptic fits and therefore required immediate attention from the staff on duty and four had limited verbal communication skills. In addition to this the property consisted of four floors and did not have a passenger lift. Prospect Hill (12) DS0000067654.V319022.R01.S.doc Version 5.2 Page 21 Consequently the staff on duty had to potentially supervise a relatively large area. In order to overcome these problems the registered manager was an integral part of the support team but this had the effect of distracting her from her managerial tasks. The night staffing consisted of two persons on-call in the premises supported by the manager or assistant manager externally. According to the staff they could ‘hear’ any disturbance or service user requiring assistance during the night. Given that one service user occasionally required the assistance of both staff during the night and others had moderate disabilities, this staffing level/arrangement, it could be argued, was not sound. The staffing level also had a direct impact on the frequency of external activities that could be provided for the service users. To an extent this had been overcome through the use of an external support worker for one service user. The home did, however, receive support from the manager and the staff of the registered provider’s other care home at Robin Hoods Bay. It was evident from the staff records that the staff had been provided with good levels of training in statutory and professional subjects. The majority of the staff had obtained a National Vocational Qualification at level 2 or above. It was recommended to the manager that given the ages of some of the service users, training should be provided in the care of the dying and bereavement. The staff presented as having an excellent understanding of the needs of the service users and of the actions they needed to take in order to meet those needs. They also demonstrated a good understanding of the elements of care, such as independence and choice, which go to provide the service users with a good quality of life. From observation of the staff it was evident that they provided care for the service users in a patient, caring and supportive manner. From discussions with the staff and an examination of the records it was apparent that the manager employed a robust staff recruitment and vetting procedure. Emphasis was not only placed on the experience and competence of prospective staff but also on their empathy with the service users and vice versa. This was achieved by prospective staff meeting with the service users as part of the recruitment process. The staff confirmed that they were provided with regular supervision by the manager and consequently had the opportunity to discuss any shortfalls in their training, competence or confidence. They also confirmed that a full staff handover was undertaken between each shift to ensure that there is a continuity of care for the service users. Prospect Hill (12) DS0000067654.V319022.R01.S.doc Version 5.2 Page 22 The records confirmed that staff meetings had taken place on a regular basis. Comments from staff included, “I previously worked in older persons homes but this (Prospect Hill) is more rewarding. I get good support and have done a lot of training. I don’t have any concerns but it would be nice to have our own transport” and “I enjoy working here and I get a lot from it”. The most striking comment from a service user regarding the manager and staff was, “She (manager) is bloody marvellous and they (staff) are bloody marvellous too”. Prospect Hill (12) DS0000067654.V319022.R01.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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 41, 42 and 43. Quality in this outcome area is good. The staff and service users are supported by a competent manager who has clear aims for the home and understands what constitutes a good standard of care. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager was in the process of taking her Registered Manager’s Award. She demonstrated a good understanding of her management duties although as previously mentioned in this report she found that much of her time was taken up as a support worker. She had clear aims for the home but acknowledged that these had to take into account staff availability. Prospect Hill (12) DS0000067654.V319022.R01.S.doc Version 5.2 Page 24 It was evident that the manager employed a democratic style of management. She had endeavoured to make best use of the staffs’ individual skills and had consequently delegated appropriate tasks. From discussions with the staff it was apparent that they enjoyed a good relationship with the manger and felt included in the decision making processes of the home. Comments from staff relating to the management of the home included, “I get regular supervision and good support from the manager”. A number of statutory records were examined. They were all up to date. In general the care records could be audited, as they were reasonably comprehensive and cross-referenced. From an examination of the health and safety related records and an inspection of the premises, it was apparent that the registered manager had taken appropriate steps to ensure that the safety and welfare of the service users and staff was safeguarded. Whilst the registered manager confirmed that the Registered Person made visits to the home, there was no recorded evidence of the outcome or frequency of these visits. The registered manager did not access to the Internet or e-mail facilities, which limited her access to current information on social care. Prospect Hill (12) DS0000067654.V319022.R01.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 X 2 X 3 3 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 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 X 30 4 STAFFING Standard No Score 31 X 32 4 33 2 34 3 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 4 X LIFESTYLES Standard No Score 11 3 12 4 13 4 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 3 X 4 4 3 X 3 3 2 Prospect Hill (12) DS0000067654.V319022.R01.S.doc Version 5.2 Page 26 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 YA33 Regulation 18(1) Requirement The day and night staffing level must be reviewed to ensure that it is sufficient to meet the needs of the service users both during the day and night. Timescale for action 01/02/07 2 YA43 26(3)(4)(5) The registered provider must make monthly unannounced visits to the home to ascertain the quality of the service being provided. A report of the findings of these visits must be provided for the registered manager. 01/02/07 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 RCN RCN RCN Good Practice Recommendations The service users’ key workers should have direct input into the reviews and development of the care plans. The staff should be provided with training in the care of the dying and bereavement. Consideration should be given to making transport more readily available for the benefit of the service users. DS0000067654.V319022.R01.S.doc Version 5.2 Page 27 Prospect Hill (12) Prospect Hill (12) DS0000067654.V319022.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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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