Inspection on 25/09/07 for Robleaze

This inspection was carried out on 25th September 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 no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Robleaze 10/10/06

Robleaze 24/02/06

Robleaze 12/10/05

Robleaze 02/03/05

Robleaze 03/08/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Robleaze 537-539 Bath Road Brislington Bristol BS4 3LB Lead Inspector Sandra Jones Key Unannounced Inspection 25th September 2007 09:30 Robleaze DS0000026552.V346236.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 Robleaze DS0000026552.V346236.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. Robleaze DS0000026552.V346236.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Robleaze Address 537-539 Bath Road Brislington Bristol BS4 3LB 0117 9720813 NONE 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) Mrs Susan Mary Robinson Mrs Claire Louise Luton Care Home 10 Category(ies) of Learning disability (10) registration, with number of places Robleaze DS0000026552.V346236.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. May accommodate up to 10 persons aged 18 - 64 years Date of last inspection 10th October 2006 Brief Description of the Service: Robleaze is a care home operated by Sue Robinson and managed by Claire Luton. It is registered to accommodate up to ten adults of both sexes with learning disabilities. The property is situated on a busy main road close to shops, parks, amenities and bus routes. Two houses were converted to accommodate the registered numbers and maintain its appearance of a domestic dwelling, which blends with its local environment. The fees at the home range from £327.00-£481.50 per week Robleaze DS0000026552.V346236.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was conducted unannounced over one day in September 2007 and focused on the assessment of key standards. The main purpose of the visit was to check on the welfare of the people who use the service, ensure the premises are well maintained and to examine health and safety procedure. During the site visit, the records were examined, a tour of the premises was conducted and feedback sought from individuals and staff. Prior to the visit some time was spent examining documentation accumulated since the previous inspection, including the AQAA and notified incidences in the home, (Regulation 37’s). This information was used to plan the inspection visit. “Have your say” surveys were sent to individuals living at the home, their relatives and health care professional. Feedback was received at the Commission from the ten people living at the home, three relatives and the consultant psychiatrist that visits the home. Ten people live at the home and four people were case tracked during the inspection. Case tracking is the method used to assess whether people who use services receive good quality care that meets their individual needs. The inspection included looking at records such as care plans and reviews of the care of people using the service and other related documents. The home’s policies and procedures were also used to confirm the findings. The views of the manager, staff and people using the service were gathered through face- to- face discussions. What the service does well: “Have your say” surveys seek feedback on what the person feels the home does well. The consultant psychiatrist stated, “Good level of care and community presence, good friendly and homely atmosphere,” and one relative said “ Provides a fun, relaxed, safe environment”. Individuals at the home participate in the care planning process and are able to describe the roles that staff perform in particular the role to their keyworker. In-house and community based activities are varied and there are opportunities for the people to use the skills learnt at the home. People giving feedback described their daily activities and the expectations of them towards independent living skills. Individuals said that the staff treat them well and that they know whom to approach with complaints. Robleaze DS0000026552.V346236.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. Robleaze DS0000026552.V346236.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 Robleaze DS0000026552.V346236.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): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Individuals must be reassured that the home will have the skills and resources to meet their assessed needs. The admissions procedure in place must be clear about the range of needs that can or cannot be met at the home. EVIDENCE: The admission procedure specifies the age range and criteria for admission to the home. Within the procedure, the arrangements for introductory visits and trial periods are described. The Statement of Purpose must be reviewed to make clear the age range and the implications for people over the 64 years. The home’s Service User Guide is symbolised by the use of pictures and words to ensure that the people for whom it is intended can understand it. Ten “Have your Say” surveys were received at the Commission from people that use the service. Seven people stated that they were asked if they wanted to move into the home and they also received enough information about the home before moving in. Two people said that they were not asked if they wanted to move into the home and one said that they did not receive any information about the home before moving in. The manager said that there are no vacancies anticipated in the near future. Robleaze DS0000026552.V346236.R01.S.doc Version 5.2 Page 9 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): Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. There are effective care planning systems in place and individuals benefit from receiving an individualised and consistent service. Action plans must be more detailed about the manner in which staff must manage aggressive and violent behaviors. Individuals at the home can expect to be involved in making decisions about all aspects of their care. Risk assessments are completed for activities that may involve an element of risk. EVIDENCE: Home’s care plans are developed from the review of needs that occurs six monthly at the home. Care plan reviews are convened by the home staff and attended by the individual, and where appropriate by their relative, manager and keyworker. Care plans are symbolised with pictures and words to increase the individuals understanding of the way their needs are to be met. The home has taken significant steps to make formats more accessible to the person. Robleaze DS0000026552.V346236.R01.S.doc Version 5.2 Page 10 Care plans are developed for each area of need and described are the actions that must be taken to meet the assessed need. A person centred approach to meeting needs is used and clearly specify the individuals likes, dislikes and preferred routines. Individuals at the home were aware of their care plan and named their keyworker and described their role. Three “Have your Say” surveys were received from relatives of people living at the home, which stated that the home always meets the needs of the individual. Individuals stated that their keyworkers assisted with domestic tasks, took them shopping and organised outings and trips. Keyworkers giving feedback stated that their role entailed the assessment of care plans, assisting individuals with domestic tasks, supporting individuals on appointments and attending reviews. It is evident from the records viewed that individuals at the home can at times exhibit inappropriate behaviours. Action plans for managing inappropriate behaviours focus on positive behaviours and where necessary the consequences are listed for behaviours exhibited. The action plans for individuals that exhibit aggressive, inappropriate and aggressive behaviours, must be more specific, incorporate the triggers, with actions to diffuse the situations and where possible the person’s signature. Where communication needs are identified care plans describe the person’s ability and needs. Care plans must be more detailed about the way the persons makes decisions and the actions staff must take to enable the person to make decisions. Members of staff giving feedback said pictures and choices are used to empower individuals at the home to make choices. Finances form part of the care plan and describe the person ability with budgeting. Risk assessments are in place for activities that may involve an element of risk, where the risk is identified an action plan is the developed on the action that staff must take to lower the level of risk. Risk assessments are reviewed three monthly and are based on competency to undertake household chores, road safety and using electrical equipment. One person will inappropriately use electrical equipment and electrical appliances that cannot be tampered with are installed in the bedroom. Sensors are also used at night to alert sleeping staff that this person has left their bedroom. Robleaze DS0000026552.V346236.R01.S.doc Version 5.2 Page 11 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): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. There are good support systems in place for individuals to lead active and interesting lifestyles and to be valued members of the community. EVIDENCE: The home’s Service User Guide details the facilities available within the local community. Shops, pubs, cinemas, parks and other amenities are within walking distance of the home. There is a daytime activity timetable that states the community based activity undertaken by the person. From skills development needs, individual’s joint interests, wishes and upcoming local events and festivals, the manager devises the in-house activity rota. Individuals at the home complete a daily activity planner that states the people at the home, staff on duty, the weather, lunchtime menu and activity. Robleaze DS0000026552.V346236.R01.S.doc Version 5.2 Page 12 The activity plan is symbolised with pictures, drawings and words to ensure that individuals can understand the arrangements for the day. Personality profiles that describe the individual’s likes, dislikes and preferred routines form part of the care plans. Within the profiles is the person’s background history, they way the person communicates, their lifestyle choices which include inhouse and community-based activities with professional involved with the persons care. Individual’s aims and goals are sought during the review and pictures are used to describe the aim. Individuals giving feedback described their daily routines and the named the activities they undertook on a daily basis. “Have your say” surveys from people at the home were received at the Commission and four people stated that they always make decisions about what they do each day, five people said that sometimes they make decisions and one said they never make decisions. Eight people said that they can do what they want during the day and eight said they could do what they wanted in the evening. The manager explained the way individuals at the home are supported to be part of the local community. It was said that individuals use local shops and are known in the local clubs and pubs, in terms of community links the manager said that individuals are seeking local employment and two people are on waiting lists for employment. There is a home’s vehicle and individuals pay a petrol allowance for using the vehicle. People at the home confirmed that they use local facilities, they use the home’s vehicle or sometimes walk and staff accompanies them. The arrangements for visiting is included in the Service User Guide, it states that visiting is flexible between 9:00 am and 9:00 pm and outside these hours prior agreements is suggested. Three “Have your say” surveys from relatives of people at the home state that the home assists the person at the home to keep in touch with family and friends. One person said that their family visit the home and they can go into their bedroom for a private chat. The home’s guidelines are included within the Service User Guide, which are symbolised with pictures and words sot that the people for whom it’s intended can understand it. The expectations that individuals participate in life skills programme and rules of the home are clearly listed. Individuals are supported to learn skills based on cooking, shopping, laundry and budgeting. Members of staff giving feedback stated each day one person has an allocated change day where the keyworker and individual go through the bedroom to assess clothing and personal space. It was further stated that volunteers for household chores are sought at weekends. Individuals at the home said that there are rules and are based on not leaving the home without staff supervision and smoking. Additional comments regarding the way staff respect them as individuals included, “I have a key to my bedrooms” and “staff knock on doors before they enter”. Robleaze DS0000026552.V346236.R01.S.doc Version 5.2 Page 13 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): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Individuals can expect sensitive and prompt support for their personal and health care needs from a skilled staff team. Safe systems of medications are in place for individuals at the home. EVIDENCE: Personal care needs form part of the individuals care plans, which are symbolised with pictures and words and describe the area of need. A person centred approach to meeting needs is used to specify the actions to be taken to meet the need. Personal profiles state the time the individuals prefer to rise and to retire, with the actions to be taken by the staff to support the individual in maintaining their preferred routine. Health care needs are held in the person’s case record. Documentation held in case records from other health care professional confirm that staff monitor the individuals needs and where necessary specialist support is sought. Members of staff record the date and reasons for health care appointments along with the outcome of the visit. Robleaze DS0000026552.V346236.R01.S.doc Version 5.2 Page 14 “Have your say” survey from Psychiatrist state that the home always meets the health care needs of the people at the home. Relatives stated through the survey that the home keeps them up to date with important issues affecting their relative. Individuals said that the staff accompanies them on health care appointments. Members of staff confirmed that they accompany individuals on all health care appointments. Regarding following advice given by health care professionals, staff said that outcome of visits are recorded in multidisciplinary reports and communication books. Medication profiles lists medication administered, the purpose of the medications administered, with the side effects and medications to be avoided. Protocols for “when required” medications state name of the medications with guidance for staff to administer the medication. Generally senior staff must sanction the administration of “when required” medication. Medications are administered from a monitored dosage system by the staff and records show that staff sign the records following the administration of medications. Homely remedies are administered from a stock supply when required by the person and records are up to date and accurate. A record of medications no longer required is maintained and the signature of the pharmacist evidences receipt of the medication for disposal. Robleaze DS0000026552.V346236.R01.S.doc Version 5.2 Page 15 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Individuals can expect their concerns to be listened to and to be protected from abuse. EVIDENCE: The home’s Complaints procedure is in picture format and will be in audio, which ensures that the people at the home can understand the procedure. The manager said that individuals at the home were provided with copies of the procedure and copies were seen in individuals bedrooms. There were no complaints received at the home for investigation since the last key inspection. Individuals giving feedback during the site visit named the person that would be approached with complaints. Members of staff giving feedback said that house meetings are forums used to raise concerns about group living. It was further stated that changes of mood may be an indication that the individual may have concerns and the person would be asked about concerns and complaints. Nine individuals stated through the “Have your say” surveys that they know who to speak to if they are not happy and six people said that they know how to make complaints. Relative’s surveys state that they know how to make a complaint and the home has always responded appropriately to their complaints. The manager said that four people at times may exhibit aggressive and violent behaviour and it’s the home’s policy to diffuse incidents of aggression or violence. This is achieved by specific knowledge of the person, knowing the triggers and developing guidelines to consistently manage potentially aggressive and violent behaviours. Robleaze DS0000026552.V346236.R01.S.doc Version 5.2 Page 16 The home’s Abuse policy defines the types of abuse and the actions to be taken which currently follows “No Secrets” guidance. The policy must also detail the procedure for staff that are the alleged abuser. The manager said that there were no Safeguarding Adults referrals since the last key inspection. Robleaze DS0000026552.V346236.R01.S.doc Version 5.2 Page 17 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): Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. The home must be maintained to an adequate standard so the people living at the home can benefit from living in a comfortable environment. EVIDENCE: Robleaze is situated on the Bath Road close to shops, amenities and bus routes. Originally two domestic dwellings adapted to provide accommodation and personal care to ten individuals. The property presents as a domestic dwelling, which blends with its immediate residential environment. While there is level access through the rear of the property, the home is not suitable for people that require equipment and aids, to maintain their independence. The property is Victorian and to fulfil the purpose of a care home, the building requires high levels of maintenance. While steps are taken to maintain the property, there are repairs that must be undertaken. Since the last inspection the dining room was redecorated and the manager said that the second dining room and quite area are next to be decorated. Robleaze DS0000026552.V346236.R01.S.doc Version 5.2 Page 18 Steps are being taken by the manager to maintain the property to an adequate standard and, a person to undertake repairs and redecoration will be employed. Accommodation is arranged over two floors, with bedrooms on both floors and shared space on the group floor. With the exception of one double room, used by siblings, bedrooms are single. Bedrooms contain furniture and fittings suitable to meet the individuals needs. The combination of the home’s furniture and personal belongings reflects individual’s personality and interests. Seven “Have your say” surveys from people living at the home state that the home is always clean and fresh. One person giving feedback during the inspection said they liked their room and it was to be redecorated in the near future. On the ground floor there are two toilets and one bathroom and on the first floor there are two bathrooms and two toilets. The ratio of people sharing the toilet is 2:5, which is above the NMS. 2:2 is the ratio of people sharing the bathrooms. The number of toilets and bathrooms are above the NMS, offering sufficient personal privacy. There is a lounge, two dining rooms and a quiet area, for shared activities and private use. In the lounge the residents can sit together and watch the television, in the quiet area there is seating for four people. Six people sit together in one dining room and four in the other. Communal space available is sufficient for residents to share activities and for their private use. The laundry room is sited away from the kitchen. The floor and walls are tiled for easy cleaning. Within the laundry room COSHH substances are kept in a secure cupboard. There are two washing machines, one is specifically for sluicing soiled linen, and two tumble dryers. Robleaze DS0000026552.V346236.R01.S.doc Version 5.2 Page 19 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): Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Individuals at the home are supported by a competent and qualified and staff team. Specific training must be considered so ensure staff can meet the changing needs of the people at the home. EVIDENCE: The personnel files of the most recently employed staff were examined and completed application forms, two references, POVA First check and Criminal Record Bureau (CRB) disclosures are kept in files. In addition to the recruitment documentation held in files there are records of supervision, training records and disciplinary reports. Individuals giving feedback said that the staff treat them well. Seven “Have your say” surveys from individuals at the home state that the staff always treat them well, they listen and act upon what they say. Two individuals stated through the survey that the staff sometimes treat them well and one person said that they were hardly ever treated well. One person said that the staff sometimes listened and acted upon what they say and one person said it was never. Robleaze DS0000026552.V346236.R01.S.doc Version 5.2 Page 20 Members of staff were consulted about access to training and it was stated that new staff have an induction followed by statutory training, which is inhouse and vocational qualification. It was further stated that the home used a training package, which is undertaken in-house and marked by the training providers. The manager said that new staff must complete the Induction and Foundation training programme, undertake statutory training and vocational qualifications. Statutory training undertaken through the in-house training package entails Manual Handling, First Aid, Food Hygiene, risk assessments and aggression. Training that is specific to meet the needs of the people living at the home that includes communication is being organised by the manager. Members of staff training needs are assessed yearly, the staff completes a training assessment and the manager discussed the content, a training plan is then developed from all the assessments undertaken. Two “Have your say” surveys from relatives state that the staff always have the skills and experience to look after the people living at the home. The “Have you say” survey from the psychiatrist states, “Dedicated team with good morale.” Robleaze DS0000026552.V346236.R01.S.doc Version 5.2 Page 21 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): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The home complies with health and safety procedures so the people living at the home can be re-assured that standards will be the subject of ongoing monitoring. EVIDENCE: The manager was consulted about the style of management used to maintain the standards of care at the home. The manager said that achieving the NVQ level 4 and the Registered Managers Award (RMA), the home is meeting the requirements to have a qualified manager and by attending short courses practices are within current guidelines. The manager said that a firm but fair management style is used to achieve the main focus of developing individuals skills to participate in all aspects of their lives. Robleaze DS0000026552.V346236.R01.S.doc Version 5.2 Page 22 Systems that maintain consistency include organising the individual’s daily routines, having senior staff on duty each day and checking the environment for repairs. Staff meetings, house meetings and supervision are also used to maintain the standards of care at the home. The manager also said that in addition to supervision, performance monitoring occurs where poor staff performance is identified so that the correct support can be provided to improve staff performance. Members of staff giving feedback said that three people make up the management team and the team is approachable. Staff confirmed that staff meetings take place monthly and they are able to make suggestions and supervision occurs 6-8 weekly. The manager intends to develop a system that runs alongside the Commission’s Annual Quality Assurance Assessment (AQAA). Fire risk analysis with action to prevent a fire was conducted in the kitchen, office, laundry, lounge, and bedrooms. The manager said that fire risk assessments were completed following the fire analysis. However, the risk assessments were not available for inspection. Fire risk assessments must be available at the next key inspection. There is also compliance with associated legislation and, competent contractors are used to check the gas boiler and electrical appliances. Facilities exits for the safekeeping of cash and valuables on behalf of the people that live at the home. It is evident that members of staff check cash balances when shift changes occur and during the checks staff were observed reconciling the records, which are up to date and accurate. Individuals schedules of fees from the funding authority are in place for each person living at the home and fees range from £327.00-£481.50 per week. The rota in place shows that additional staff are rostered during peak periods, up to four staff are can be rostered during the week. At weekends two staff are rostered with one-person sleeping-in at night. Robleaze DS0000026552.V346236.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 x 2 3 3 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 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 x 33 x 34 3 35 2 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 2 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 2 x x 2 x Robleaze DS0000026552.V346236.R01.S.doc Version 5.2 Page 24 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 YA24 YA1 Regulation 23 6 Requirement Repairs must be undertaken to maintain a safe environment. The Statement of Purpose must be reviewed to make clear the admission procedure. The range of needs that can and cannot be met at the home must be made clear. The care plans for people that exhibit aggressive and violent behaviours must be specific for staff to diffuse and divert these behaviours. Care plans for people with communication needs must be more specific about the way decisions are made and the actions staff must take to enable the person to make decisions. Training that is specific to meet the changing needs of the people at the home must be provided. Timescale for action 30/03/08 30/01/08 3. YA6 15(1) 30/12/07 4. YA7 17 (1) (a) Sch.3.l 30/12/07 5. YA35 18 (1) (c) (i) 30/03/08 Robleaze DS0000026552.V346236.R01.S.doc Version 5.2 Page 25 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 Robleaze DS0000026552.V346236.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG 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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