Inspection on 21/08/07 for Radnor House

This inspection was carried out on 21st August 2007.

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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 16 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Radnor House 04/11/08

Radnor House 13/11/07

Radnor House 05/07/06

Radnor House 14/11/05

Radnor House 13/04/05

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Insight - Eastchurch

Southfields

Thorndene

Magenta

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Dovedale Court

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

CARE HOME ADULTS 18-65 Radnor House 139 Canterbury Road Hawkinge Folkestone Kent CT18 7AX Lead Inspector Lois Tozer Key Unannounced Inspection 21st August 2007 09:25 Radnor House DS0000061367.V346007.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 Radnor House DS0000061367.V346007.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. Radnor House DS0000061367.V346007.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Radnor House Address 139 Canterbury Road Hawkinge Folkestone Kent CT18 7AX 01303 894693 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) Caretech Community Services Limited Vacant Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Radnor House DS0000061367.V346007.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: 2. Learning Disabilities (LD) The maximum number of service users to be accommodated is 6. Date of last inspection 5th July 2006 Brief Description of the Service: Radnor House is owned and operated by CareTech Community Services Ltd and is registered to provide accommodation and personal care to a maximum of 6 persons within the age range 18 to 65 who have learning disabilities. It was first registered in October 2004 under the Care Standards Act 2000. It is a detached property situated in the centre of the village of Hawkinge, Kent. The layout of the home is suitable for people who are mobile within the home. It comprises of four single bedrooms situated in the main house and two semi-independent flatletts that are accessed via the main front door. These have individual front doors within the main building that are fitted with a key code panel. All bedrooms have en-suite facilities and the flats have full bathing facilities plus kitchenette. There are two bathrooms with WC facilities and one separate WC. There is a large L shaped lounge / diner that opens onto the secluded rear garden, access is often restricted. A small room off the used as a quiet area but can be used as a separate dining room if required. There is a central kitchen for the preparation of all main meals. A shinglecovered car park to the front of the premises allows parking for approximately 8 vehicles. There is an administration office for the secure storage of information and a dedicated medication room. A cellar is available for storage, however is not in day-to-day use. The current weekly fees are in the range £1542.60 - £2568.80. Copies of the statement of purpose, service user guide and previous reports can be obtained from the home, as can the action plan to address the identified improvements. Radnor House DS0000061367.V346007.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key site visit took place on 21st August 2007 between 09.25am and 5.15pm. The manager has been in post for three weeks She, service users and staff assisted with the inspection process. Six people currently live at the home, four gave face-to-face feedback. Service user comment cards were also received before the visit took place. Family, GP and care manager surveys were sent out, several family and one GP comment were returned, but no care management comments. Some activities were taking place during the visit, and observations formed part of the evidence collected. The communal areas of the main house, medication room and a bedroom and an apartment were seen during this visit. The inspection process consisted of information collected before and during the visit to the home. We also saw information such as assessment and care plans, duty rota, risk assessments and service users finances paperwork. Lots of work is in progress, and much of this visit centred on discussing the managers and service users plans. The manager completed the Annual Quality Assurance Assessment prior to the visit, which gave us an indication that the manager clearly recognises where improvements are needed in the home. What the service does well: Some people say that the support they got choosing the home was good, and they are very pleased to live here. Some individual plans and communication packs are good, and help people to make decisions about their lifestyle. Some activities are also enjoyed, and some have been chosen by the service users. Some people are encouraged to go into the kitchen and help make their own drinks and wash up. Staff look after all of the medication, and they make sure its safe. There are some plans to help people to do more for themselves in this area. The furnishings and building are in good condition. Service users like the staff. An experienced manager has been recruited. Radnor House DS0000061367.V346007.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: The assessments that were done before the service user moved in contain important information that hasn’t been put in the care plan. The care plans are in a muddle, and need sorting out and making simpler. Information from psychology assessments that has been conducted has not been followed up. Everyone needs to be involved with communication about the home, so putting menu’s, rota and other things in a way everyone understands is important. Staff should use signing much more, so the signing service users can be involved in the general chitchat of the home. Some people have severely limited lifestyle opportunities. There are no structured plans and those in place are not being followed. Staff need better support to give the service users the support they need. People need better support to prepare and eat healthier meals. Personal care needs to be discussed with the individual, and an agreement based on support needs put in place. The complaints procedure and policy needs to be easy for service users to use. The home must be kept safe with regular checks, and the maintenance be carried out quickly. People want access to the laundry and to take more control over their lives. Lots of agency staff are being used, which means service users can’t form the type of trusting relationships they should get from a support team. Please contact the provider for advice of actions taken in response to this Radnor House DS0000061367.V346007.R01.S.doc Version 5.2 Page 7 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. Radnor House DS0000061367.V346007.R01.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 Radnor House DS0000061367.V346007.R01.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. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Pre-admission history needs to be found and the relevant information incorporated into revised assessment plans to make sure fundamental needs are met. Urgent reassessment of service user needs must take place. EVIDENCE: Service users have had pre-admission assessments conducted; they have been available on previous occasions. They could not be found during this visit, and much of the information that is contained within them that is still relevant (health, family contact preference and so on) but has not been transferred into the current plan. There was no way of seeing if original assessed aspirations and needs had developed or were being supported in the way that had been agreed when the placement was purchased. Evaluations, where conducted, had not taken these into account. There was strong indications that two service user needs were being minimally met. One person spoke up and said they wanted more say in their life. The new manager has already started to address this and was able to give reassurance that service users will be consulted about their support in a person centred way. A fully revised needs and aspirations assessment for one particular person is urgently required. The home must not offer placement to people it does not have the skills to meet. Radnor House DS0000061367.V346007.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, 9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Some service users needs and decisions are very well supported, but other people are receiving a poor service that has not been adequately assessed and addressed. EVIDENCE: Two people at the home said they were very happy, and the service was meeting their needs. One person felt certain that they would be helped to move on, and for now, the home was fine for them. A person indicated using pictures that they were unhappy and wanted more say in their lives, and that they would like to use the washing machine when they wanted to. People who have hard to meet needs live in the home and pay a lot of money each week for the service. The quality of life portrayed in the daily records does not reflect the plan’s aims. The plans seen were in the process of being reviewed as they were so fragmented they were very difficult for staff to follow. Some person-centred Radnor House DS0000061367.V346007.R01.S.doc Version 5.2 Page 11 plan paperwork was being done, but was not as yet engaging the individual. Staff were writing their views and opinions about the person, but had not organised planning meetings with people the individual would want involved. Only one non-verbal person had a good picture reference communication pack, so could indicate decisions and make choices. This was being used each day. Other people were relying on staff interpreting or assuming their preferences. Risks to an individual from social isolation, lack of dignity and low self-esteem were evident. Needs assessments and reviews had not been completed, and the very clear specialist support the person needs has not been supplied. The funding arrangements for the person are high, but there has been no specialist support provided by the organisation. Independent psychologists have questioned the suitability of the placement for the individual, yet nothing has changed. An ‘safeguarding adults’ referral has been made to the local social service adult protection team. The manager is totally clear that these shortfalls are a priority, and has an action plan in place to address the problems, so no requirement has been made. Radnor House DS0000061367.V346007.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): 12, 13, 15, 16, 17 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users need more control choosing their activities and lifestyles, but they need staff to guide them to make healthy choices and present choice in a way that is accessible for everyone. EVIDENCE: Some service users are taking part in activities that they enjoy and they have chosen. Others have been socially isolated for a very long period of time, and this has not been adequately addressed. Consequently, the person has an impoverished lifestyle and there were no plans in place to improve on this. The new manager does have the appropriate skills to assess this situation and has started to take action to improve the situation. The home is well placed for community access, and most people get to go out and about regularly. Several people have poor activity plans, and no forward planning has happened to put activities in place when the college has finished for summer. Radnor House DS0000061367.V346007.R01.S.doc Version 5.2 Page 13 One person said, using pictures and signs, that they were bored with their lifestyle. Where people have stopped enjoying activities, reviews have been slow, and so records show that they are spending many daytime hours in the house or their rooms, but not constructively engaged. Most people have regular family contact, but clear instructions from family about who to contact have been lost within the pre-admissions assessment and not been transferred into the working information. This has caused family some distress, and records need to be reviewed to reflect such information. Service users are not encouraged to answer the door to callers; instead staff are letting themselves into the house using the number punch pad. Service users are not fully involved in menu planning, the staff engage with one person or so per week, and it is represented in a hand written plan. During the visit, a service user was given pizza and chips, but rejected the pizza. Staff made a cheese sandwich as a replacement. We discussed how more empowering choosing the food using pictures on a daily basis could be, and how service users could become more involved in making their own lunches. Looking at the range of food available, much is high calorie / low fibre type items (frozen products, chips and pie type things). Two menu sheets showed that over the week prior to the visit, only 3 portions of vegetable had been featured on the menu. Some care plan records indicated that healthy eating would be essential for managing particular health needs, but was not being incorporated in practice. Radnor House DS0000061367.V346007.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, 20 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Medication is managed in a safe way by staff on service users behalf, but personal and health care support must improve so people get the right support for their needs in the way that they want it. EVIDENCE: Individual support for personal care is documented, but has not considered service users support needs from a developmental point of view. In discussion with a service user, it was made clear that they would like more help, but not in a bossy way, and would accept it if it was in they way they choose. There has been a tendency to see refusal as client choice, and this has decreased personal support provided. Family report that self-care skills have decreased, and their relative has been unkempt in appearance. Some really important health information was missing from the file, which has an impact on daily health management. Staff ‘know’ about health issues through a process of hearsay, which is dangerous. The manager has already started implementing ‘health action plans’, and this should help resolve both health and personal care issues. One individual’s mental health support needs Radnor House DS0000061367.V346007.R01.S.doc Version 5.2 Page 15 have been neglected. Although help has been sought with the local learning disability team, it has not yet been obtained. The new manager has sought to build links to improve support for this person. Medication management currently takes place from a central room and is organised and administered by staff. Records and facilities are in good order. The staff member in charge has had a good level of training and was able to demonstrate a good knowledge of this subject. Some minor improvements were discussed (filling in the returns book with spoilt meds straight away), but overall this is a well-organised area. One service user saw our picture of a person administering their own medication, and without prompting, indicated the action of popping out and pointed at themselves. Asked if they wanted to look after their medication, they nodded rapidly. This was fed back to the manager and staff member and could have good potential for development. Radnor House DS0000061367.V346007.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, 23 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Some service users need much better support to feel well cared for and protected from abuse, neglect and self-harm. EVIDENCE: When asked by us, three service users said or indicated using pictures and signs that they would be able to tell staff if there was a problem. One person indicated that although they liked the staff, they did not feel well cared for, while another felt that the staff were perfect for their needs. One person pulled a very sad face when asked, using pictures, if they were happy or not happy. The complaints procedure is not accessible to service users. It lives in a file in the office, is written in text, with some pictures, and there is no system to help people self advocate or learn how to speak up. Staff have had adult protection training, and do understand the main forms of abuse. Over time, long-term behaviour presented by a service user has been widely accepted. As such, institutional acceptance has led to a potentially abusive situation occurring. Support through care plans has been inadequate; staff have not followed the approaches consistently. Review and reassessment has not occurred, so acceptance of challenging behaviour has set in. By not taking adequate action to try and support people better is neglectful. The home says it offers a specialist service, yet has not employed any specialists to Radnor House DS0000061367.V346007.R01.S.doc Version 5.2 Page 17 guide the staff to attempt to meet needs, relying on the 1-day training courses to provide enough education to meet these complex needs. The current manager has resolved to get this sorted out. There is an accountable, central system to look after service user money, and people can get hold of spending cash easily. Radnor House DS0000061367.V346007.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, 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is reasonably comfortable and clean, but maintenance needs to improve, and the temperature of communal and individual rooms should be monitored. Access to communal laundry and garden must be assessed and improved. EVIDENCE: The home is situated on a busy road near the centre of a village. The front garden is quite untidy, which should be improved, so it reflects more positively on the service users. Access for service users to the rear garden is by way of an electronic button to open the door. This means that service users must have the ability to carry out this action if they wish to go outside into the safe garden independently. Staff said that they are always available to let people out / back in again, but this does not help promote free movement and independence. There are no clear risk assessed reasons for such a restriction. Radnor House DS0000061367.V346007.R01.S.doc Version 5.2 Page 19 Staff have been coming into the home without signalling their arrival by ringing the bell, but by letting themselves in via the number pad. Service users therefore do not get the opportunity to answer their front door, greet people or even refuse people entry. Such actions indicate that the home needs to examine equality and diversity within the home. The manager has a clear plan to improve this. It would be beneficial to find out why there is a number pad in place, rather than a door key. As a safety measure, the number pad code ought to be changed when staff member’s leave and considering the high level of agency staff use, on a frequent basis. The temperature of the home upon arrival was unusually hot and humid, and one service users bedroom had the heat on full and the window shut. There were few communal windows open. We had concerns that this environment could cause dehydration, as it was so uncomfortable. A service user was mopping their brow, but opened the window and turned the radiator off at our request when we were talking in their room. One of the two bathrooms was out of action, due to a broken window, this had been reported, and was awaiting a glazier. Care plan information indicated that service users were not supported to clean their rooms, and so an acceptable level of cleanliness was not being maintained. Care plans had been written to say a person did not want or need support, but after spending time with the person and observing the room, it seems clear that more support is needed – but how it is given needs negotiating. This is also a view held by the family A relative reported that maintenance issues were often slow to be resolved, naming broken furniture and washing machine. At the visit, a service users radiator cover was hanging off and a fire door would not shut independently. There was no evidence that these had been reported. The tumble drier had broken down, and there was no indoors airier to use while it was out of action. The laundry is locked, and this prevents people from washing their own clothes. There are no arrangements in place to give people the chance to go in the room regularly. Staff raised concerns that people may take each other’s clothes if the laundry were unlocked. This risk has to be weighed up against the bigger restriction of locking the door. A lesser restrictive solution should always be sought. . Radnor House DS0000061367.V346007.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, 34, 35 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The staff team are enthusiastic and want to improve people’s lives, but they lack the support of specialist training and a consistent team to make this happen. EVIDENCE: Staff are encouraged to use Makaton signs with service users, which is an assessed need, but only 4 of the 17 care staff have had basic training. A range of 1-day training courses in autism, epilepsy and medication management, as well as courses covering non-violent crisis intervention has been provided. The complex needs of some service users are not being met, and this needs to be resolved. Staff need the right skills and support for the job. The manager said the she is committed to securing the right training for the service user group needs. All have had, or are undergoing Learning Disability Award Framework inductions and work packs. Although individual planning is set to improve, training around person centred planning would help staff support people to have a bigger say in their lives, which she also plans to do. Radnor House DS0000061367.V346007.R01.S.doc Version 5.2 Page 21 The staff team were kind and enthusiastic, and showed lots of skills and competence, but need further support to engage with people who have complex behaviour better. Staff need support to engage people in ordinary life activities and do things in the home that they are able to participate in. Staff numbers are provided to meet service users needs. Two staff have completed NVQ level 2 or above. The manager is an NVQ assessor, and hopes to improve this figure. Service users were able to say or indicate they are happy with the level of staffing. Records showed that the use of agency staff is very high and uses a wide variety of people as support workers. Shifts covered by agency workers since May 2007 to the visit date totalled 278 shifts. There are currently 7 full time posts vacant. Staff provision was sufficiently concerning at the last visit to warrant a requirement, which has not been met. A recruitment drive is underway to address this, and the manager is booking agency staff in advance to establish better continuity. Recruitment practices are solid, and all the right checks are made prior to staff commencing work. Radnor House DS0000061367.V346007.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users have had a disrupted and inconsistent management arrangement for several years, which has not provided stability or potential for development. EVIDENCE: The manager had been in post for 3 weeks at the time of the visit, and is currently in an ‘acting’ capacity. The home has had 3 managers in the 3 years it has been open. In this time, deputy managers have ‘acted up’ while registered managers have been seconded. Neither the service users nor staff have had much stability. To her credit, this manager had already identified most of the issues found during this visit, and had started to take action to put these right. She submitted her AQAA report before the visit, and said she will Radnor House DS0000061367.V346007.R01.S.doc Version 5.2 Page 23 build on this and use it as a quality development tool. She has all the right skills and training to make a very positive impact on the improvement of the home, including a Diploma in applied psychology and challenging behaviour. She recognises that the service users quality assurance (QA) tools do not meet their needs, and must be simpler and reflect what is important to them. The organisation is undergoing a big QA review at present. Health and welfare wise, putting environmental risk assessments into practice needs improvement. A service user had a serious injury, and this had not been reassessed. Discussed with the service user and manager, there was a possibility this could happen again, and therefore action needed to be taken. Fire risk assessments do not seem to have been signed off by a trained person, and the general day to day safety of fire doors in the home is not being picked up. One bedroom door stuck open, offering staff no protection. The manager said that action would happen straight away. Staff have had health and safety training, but how far this covers keeping environments safe and taking action is not known. Radnor House DS0000061367.V346007.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 1 3 1 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 1 ENVIRONMENT Standard No Score 24 2 25 2 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 2 33 X 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 1 2 X 2 X LIFESTYLES Standard No Score 11 X 12 2 13 2 14 X 15 2 16 2 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 1 1 3 X 2 X 1 X X 2 X Radnor House DS0000061367.V346007.R01.S.doc Version 5.2 Page 25 YES 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 YA2 Regulation 14 (1) (a, b, c, d) (2) (a, b) Requirement YA2 – To make sure service users assessed needs are being supported in the way agreed, obtain and extract the important information in the needs assessment. YA3 – Conduct an urgent assessment of support and lifestyle needs for one particular person, making sure quality of life considerations are paramount. Outstanding requirement – timescale 1/9/06 unmet. Communication training to be in sufficient depth to enable staff to make a thorough assessment of the Service User’s needs and keep this under review. Timescale for action 01/10/07 2 YA3 12 (1) a, b) 14 01/09/07 33. YA7 14 18 (1) (c) 01/09/07 4 YA18 12 13 (1) (a, b) 16 (2) (i) 13 (6) 5 YA23 YA18 & 19 – Health action plans 01/10/07 need to make clear individual health support needs and how the individual wishes to be supported. YA23 – To protect service users 01/09/07 from abuse and neglect, improvements to the assessment, training and support process are urgently needed. DS0000061367.V346007.R01.S.doc Version 5.2 Page 26 Radnor House 6 YA24 23 7. YA35 18 (1) (a, b, c) YA24 – To make sure that the home remains accessible, comfortable, safe and homely to everyone living there, reassess access in and around the home, and the level of support people are given to care for their own environment. Outstanding requirement – timescale 1/9/06 unmet. There is a need for recruitment of permanent staff at the home, so as to ensure a staff team is employed who will undertake all relevant training, including communication training, and can be closely monitored by the home’s management. 15/09/07 01/10/07 8 YA35 9 YA39 18 (1) (c), YA35 – To maximise service 01/10/07 ( i & ii) users lifestyle opportunities, staff must be supported to develop the skills required to support the assessed needs of each individual. 24 YA39 – To give all service users 01/11/07 a say in running and developing the home, a quality assurance process must be in place that meets their personal communication needs. 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 Radnor House DS0000061367.V346007.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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. Extracts may not be used or reproduced without the express permission of CSCI Radnor House DS0000061367.V346007.R01.S.doc Version 5.2 Page 28 - 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. 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