Inspection on 01/06/05 for Seastrole

This inspection was carried out on 1st June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Seastrole 19/07/06

Seastrole 25/10/05

Seastrole 02/11/04

Seastrole 19/05/04

Similar services:

Clouds House

Closereach

Westcliffe House

Hilldales

Longreach

Chandos House

Cherry Orchards Camphill Community Ltd

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

CARE HOME ADULTS 18-65 Seastrole 12 Campbell Road Boscombe Bournemouth Dorset BH1 4EP Lead Inspector Julia Mooney Unannounced 1 June 2005 11am 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 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 Stationary 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. Seastrole D55 S3954 Seastrole V230574 010605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Seastrole Address 12 Campbell Road Boscombe Bournemouth Dorset BH1 4EP 01202 392241 01202 300338 Telephone number Fax number Email 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 Lorraine Pamela Parry Ms Maria Ladeira CRH PC - Care Home Only 13 Category(ies) of A Alcohol depend past/present (13) registration, with number D Drug dependence past/present (13) of places Seastrole D55 S3954 Seastrole V230574 010605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None. Date of last inspection 2nd November 2004 Brief Description of the Service: Seastrole and Larkins are two separate properties forming part of the Quinton House Project. The houses are adjacent properties located in Campbell Road, Boscombe. Seastole has five single rooms and four double two of which are ensuites. Outside there is a good sixed garden with garden furniture and two summerhouses. The homes are located within easy reach of the shopping centre at Boscombe. Also available are local and national bus and rail routes. Service users enjoy the easy access to local beaches and shopping centre. Seastrole offers residential support to 13 people of both sexes recovering from chemical dependencies and operates the 12-step programme which can be modified to meet the needs of the individual. The treatment offers a holistic approach to chemical dependencies. Service users at Seastrole can expect to stay between 12 weeks and 6 months depending on assessed needs of the individual. If accepted on to the treatment programme, service users must agree to the various house rules and restrictions imposed if they are to gain maximun benefit. Seastrole D55 S3954 Seastrole V230574 010605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection visit was unannounced and started at 11:00am on 1st June 2005. It was conducted as part of the normal routine of inspecting twice during a twelve month period. The registered provider – Mrs Parry, the registered manager - Ms Ladeira, three service users and three staff all assisted the Inspector in the work. Methodology used included a tour of the premises, review of records and discussions with service users and staff. The inspector also reviewed the contact sheet for Seastrole and Regulation 37 reports submitted by the registered provider since the last inspection. Not all of the National Minimum Standards were assessed on this visit. Please note where a National Minimum Standard was not assessed the score is shown as x. What the service does well: Service users’ needs are particularly well assessed pre-admission and on admission to the home. Care plans are well maintained and service users participate in their formulation and review. More than one service user spoken with stated that they “felt safe and supported” at Seastrole. From speaking with staff, they endeavour to create a homely, supportive, trusting atmosphere at the home and encourage service users to develop as individuals during their treatment programme. Service users are treated with respect by staff at the home. Service users are encouraged to maintain links with their families and friends during treatment and staff arrange family conferences as part of treatment if necessary. The home has comprehensive policies and procedures covering all aspects of daily living at the home. A service user informed the inspector that the registered provider paid for private chiropractic treatment as he was in so much pain. This gesture was something “he will never forget”. Records supported his statement. Seastrole D55 S3954 Seastrole V230574 010605 Stage 4.doc Version 1.30 Page 6 The physical needs section of the care plans seen (3) were particularly well maintained and staff do all they can for service users who experienced medical problems during their stay at Seastrole. Records evidenced that service users’ physical and emotional needs were met during their treatment programme. Service users are supported by a sufficient number of key workers who are suitably trained and qualified. Staff spoken with impressed as friendly and caring and from speaking with service users, they stated that they “are well respected”. The home promotes good practice in relation to safeguarding the health, safety and welfare of service users. 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. Seastrole D55 S3954 Seastrole V230574 010605 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Seastrole D55 S3954 Seastrole V230574 010605 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 The particular needs, aspirations and restrictions of service users’ are assessed by professional people, discussed with all parties involved and agreed prior to admission to the home. This means that service users can be confident that the care they receive will be tailored to meet their individual needs. EVIDENCE: Professionals such as Care Managers, Probation Officers and specialised drug workers from HM Prisons make referrals to Seastrole. The home has a clear referral policy and procedure which was seen on this occasion. Seastrole has comprehensive assessment documentation that is completed by staff only when they are suitably experienced to do so. When a service user is admitted to the home, further assessment forms are completed in accordance with the homes’ admission policy and procedure. Records indicated that the assessment of prospective service users is very thorough. Service users spoken with confirmed that pre-admission and admission procedures were thorough. One stated that “staff have far too much paperwork to complete”. Some stated that they were admitted from prison so a telephone assessment and the assessment by prison staff resulted in them being admitted to the home. Records confirmed this. Two service users spoken with stated that they spent a full day at the home as part of the assessment process. Seastrole D55 S3954 Seastrole V230574 010605 Stage 4.doc Version 1.30 Page 9 Records indicated that service users’ are registered and seen by a GP within 24 hours of arrival at the care home. Seastrole D55 S3954 Seastrole V230574 010605 Stage 4.doc Version 1.30 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,9 There is a high level of service user participation in formulating care plan needs and goals, and the plans and reviews were signed by the service user and key worker. This ensures that service users know what their plan contains and that they will work with staff to achieve their goals. The nature of recovery programmes does mean a curtailment of certain day to day movements e.g. going out alone. These restrictions act as safeguards and are an accepted part of everyday life in a recovery programme. Service users indicated that they were aware of this before accepting treatment and pointed out that it is clearly stated in the homes’ statement of purpose/service users’ guide. N Whenever appropriate, service users are enabled to make decisions for themselves. Each person has a personal risk assessment on file with the aim of promoting independence. They are regularly reviewed, signed and dated by the service user and key worker. Responsible risk management ensures service users feel supported in their progress towards a chemical dependence free future. Seastrole D55 S3954 Seastrole V230574 010605 Stage 4.doc Version 1.30 Page 11 EVIDENCE: Three service user files were case tracked during the inspection process. In all three cases there were no care plans from the referrer. The registered manager stated that this was often the case despite the home requesting one. The registered provider said that visits from care managers are variable but the home is in contact with them regularly. The three files examined held individual plans. Records indicated that they lead on from the initial assessment and detail the treatment programme on offer at the home. Plans were comprehensive detailing personal aims, goals and action necessary to achieve these goals. All sections of the care plan were fully completed and a review date was evident. Formal reviews take place at least every 6 weeks but the plans are updated when significant events occur or any change noted. Some plans contained new goals set as a result of a review. Discharge documentation was appropriate and included those service users who chose to self discharge. The inspector spoke with the three service users whose plans were examined. They confirmed that they were fully involved in the formulation of care plans. They complete half the plan during their first week, it is then finalised with their key worker at a later date. Records evidenced that staff and service users sign and date plans and reviews. Each service user at the home has a key worker/counsellor. Appropriate risk assessments form part of the plan. Records kept at Seastrole indicate that the service users are fully involved during their stay at the home. Some service users day to day movements are restricted. They are aware of this before accepting treatment and it is clearly stated in the homes’ statement of purpose/service users’ guide e.g. specific orders from the Court such as being fitted with a tagging device. Records examined recorded restrictions imposed by the Courts. There is a system in place allowing service users to withdraw money from their funds only between 10:00 – 10:30 daily. Service users spoken with felt the system to be adequate and stated that the service users’ guide and admission documentation informs them of the restrictions. Staff spoken with were fully conversant with the homes’ risk management policy and procedure. They stated that they received guidance from management regarding completion of individual risk assessments. Records evidenced that each individual has an appropriate risk assessment in place. The home often accommodates service users who are subject to Court Orders such as Drug Testing and Treatment Orders. On this occasion, one service user was subject to a Drug Testing and Treatment order. Details were clearly outlined in this person’s risk assessment. Seastrole D55 S3954 Seastrole V230574 010605 Stage 4.doc Version 1.30 Page 12 There is also an environmental risk assessment for the home which was seen on this occasion. It is completed by the member of staff responsible for this area and reviewed monthly. Seastrole D55 S3954 Seastrole V230574 010605 Stage 4.doc Version 1.30 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11,13,15,17. Staff promote personal development for service users as much as possible in their daily lives, and within safe boundaries in the home environment and wider community. This means that service users lead fairly independent lives whilst safely accommodated at Seastrole. Service users have a varied social life and are involved in some leisure activities during the course of a week. Service users maintain links with their families and friends and are encouraged to seek support and friendship in the wider community. Meals offer choice and variety and special diets are catered for. Service users spoken with stated that they were involved in menu planning. Seastrole D55 S3954 Seastrole V230574 010605 Stage 4.doc Version 1.30 Page 14 EVIDENCE: Records evidenced that therapeutic group topics for service users include personal safety, relapse prevention, sexuality, relationships, change, lifestyle aspirations, grief & loss, the 12 steps and assertiveness, anger management, stress, relaxation, and creative groups such as music therapy and art work. The registered provider stated that the theory underpinning the programme is the Bio-psycho-social model of intervention. The current service users participate in the local community in a limited way. Records indicated that service users attend an Information Technology course at Bournemouth College on Wednesdays and the YMCA gym. The manager stated that two service users attend guitar lessons at a local drop in centre. Previous service users have been involved in a recovery workshop and various social activities at local churches. The activity is initially discussed with the service users’ key worker then permission is sought from the resident group. Staff support service users in these activities but are not directly involved in the actual activity. Service users spoken with felt that there was insufficient time to get too involved in local community as their day was fairly structured. The home has a “visits” policy, which clearly states that service users are not allowed visits for the first 3 weeks of their stay although, if children are distressed because a parent is missing from the family home, then exceptions are made. After the first three weeks, visits are encouraged and arranged. One service user spoken with said that staff had been very supportive in relation to family contact and visits. This persons’ file detailed the family issues and goals set to help the situation. Service users are not encouraged to see family or friends in their rooms. Although there is an office at Seastrole for private conversations, service users and their family/friends are also able to use the room in Larkins next door. Two “Summer Houses” in the garden provide additional areas for service users to speak privately with their visitors, but in the main, service users and their family/ friends go out. The home offers family conferences and family therapy sessions if required. The inspector examined the menus at Seastrole and they were found to be varied and nutritional. A four weekly menu rota operates and always includes a vegetarian option. In accordance with a recommendation made as a result of the last inspection, the registered provider has altered the menus so that they clearly indicate what each service user ate daily. Religious/cultural preferences are taken into consideration on admission. Special diets are discussed on admission and appropriate meals are provided. One service user was on a low fat diet and this was recorded. Seastrole D55 S3954 Seastrole V230574 010605 Stage 4.doc Version 1.30 Page 15 Service users spoken with said they are” able to discuss menu changes for the following 4 week rota”. Drinks, snacks and fruit are available at any time of the day and service users have their own fridge in the dining area. Breakfast includes cereals, toast and fruit Seastrole D55 S3954 Seastrole V230574 010605 Stage 4.doc Version 1.30 Page 16 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19,20 Personal support is offered in a way that promotes service users’ privacy, dignity and independence. Policies and procedures relating to the health care needs of service users promote good practice and ensure physical and emotional needs are met. Medication held at the home is well managed to ensure that service users medication needs are met and they are protected through the policies, procedures and practices of the home. EVIDENCE: Each service user has a designated key worker and one to one sessions usually take place in the office, but sometimes they take place in the community maybe over a cup of coffee in a café. These one to one sessions occur weekly and the service user’s individual plan is referred to throughout. Records were examined and the notes were well maintained, signed and dated by the key worker and service user. The notes are also signed and dated by the registered provider once a month. Service users are required to be in their rooms by midnight and no showers or baths are to be taken after 11pm. Breakfast is available between 8-10am to which service users help themselves, lunch is served at 1pm and service users Seastrole D55 S3954 Seastrole V230574 010605 Stage 4.doc Version 1.30 Page 17 are expected to spend at least 20 minutes at the table. The main meal of the day is served at 5.45pm and again, service users are expected to spend 20 minutes at the dinner table. Service users spoken with stated that communication forms part of life at Seastrole and meal times were an opportunity to talk with peers and staff. “Mealtimes are very informal and give us a chance to catch up”. Service users spoken with said they were “encouraged to manage their own healthcare” and are “given the choice of three GP surgeries with whom to register when they first arrive at the home”. The registered provider stated that they are also “encouraged to attend well woman or well man clinics”. Service users confirmed that they are “able to access any dental surgeries and/or High Street Optician should there be a need”. Should a service user need to attend outpatient departments, they are is likely to be accompanied by a peer rather than a member of staff although staff would accompany if it was felt to be necessary. Records indicated that health issues are regularly reviewed by service user and key worker. The homes’ accident book was examined. Three entries were all recorded appropriately. The incident book contained numerous entries, three of which recorded that the service user was taken to Accident & Emergency department. The inspector received three Regulation 37 reports in respect of these A & E visits and spoke with a service user who needed hospital treatment. He said “staff could not do enough they were brilliant, and Mrs Parry even paid for chiropractic treatment in order to help me with my back problem”. The medical/physical section of care plans were particularly well documented for two service users who needed specific treatment during their stay at Seastrole. The home has a medication policy and procedure. The inspector examined the medication records and they were found to be well maintained. The home is currently holding medication for two service users and one service user was self medicating. Risk management assessments were completed for this service user and the medication administration record chart was appropriately maintained with the date they are due to complete the course, diarised in the office diary. Staff spoken with stated that they “periodically check the medication stock held by service users”. Records evidenced that this was the case. Any medication held on behalf of service users is stored in a locked metal safe within a locked office. The safe is immobile and the key to the safe is stored in a locked cupboard. The registered provider stated that all staff had received training in medicines from both an external source and in house training. Copies of certificates were seen on this occasion. Seastrole D55 S3954 Seastrole V230574 010605 Stage 4.doc Version 1.30 Page 18 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22,23 The home has a satisfactory complaints procedure with evidence that complaints are investigated and complainants receive notification of the outcome. Service users spoken with stated that they “feel their views were listened to and acted on”. Written policies are in place at the home to safeguard service users against abuse, neglect and self harm. EVIDENCE: The homes’ complaints policy and procedure is satisfactory. The home keeps a record of complaints made and the record is regularly signed by the manager and registered provider to evidence that complaints are being monitored and appropriately dealt with. There have been no complaints at the home since the last inspection. Service users spoken with confirmed that they received a copy of the complaints procedure when they were first admitted to the home. The registered provider has attended local meetings/training on “No Secrets” and has shared the information with her staff. The home has Abuse and Whistle blowing policies and procedures. Staff spoken with were aware of what to do in the event of abuse or suspected abuse occurring at the home. The home has a clear procedure for dealing with aggression, violence and verbal abuse and response is graded e.g. verbal warning initially. There is a policy and procedure regarding Restraint that does not advocate the use of physical restraint. Seastrole D55 S3954 Seastrole V230574 010605 Stage 4.doc Version 1.30 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,30. The home provides an attractive, clean, spacious and homely place to stay. However, improvement to the décor in one bedroom and at least one new chest of drawers would enhance service users’ bedrooms. EVIDENCE: Seastrole has 4 double and 5 single rooms, a service users lounge, kitchen and dining space within the kitchen. The laundry facilities are shared with Larkins next door. The office is situated on the first floor. The home is comfortable with most of the accommodation domestic in scale, the kitchen is industrial size and meets with the requirements of the local environmental health department. Records evidenced that the premises met the requirements of the Environmental Health Department and local Fire & Rescue Service. A tour of the premises accompanied by the homes’ maintenance manager, revealed that the office, lounge and a bedroom had been decorated and new carpet fitted in the dining room, office, one of the bedrooms and stairwell/hallway. In addition, the shower in the en-suite bedroom had recently been replaced by the maintenance manager. However, the inspector noted that one of the bedrooms would benefit from a new chest of drawers and another from decorating. Seastrole D55 S3954 Seastrole V230574 010605 Stage 4.doc Version 1.30 Page 20 The home was warm, clean and comfortable on the day of inspection. The standard of furniture, fittings, bedding, curtains and general decoration was good. There is a planned programme for decorating and maintenance tasks are completed as and when necessary by the homes’ maintenance manager. Written records are kept and were seen by the inspector on this occasion. The home was clean throughout and free from offensive odours. Service users spoken with stated that they “discuss cleaning rotas in their community meetings”, own rooms are cleaned each day, communal areas daily with Wednesday’s clean being more in depth, and a weekly clean through takes place on Saturdays. Service users were undertaking cleaning chores on the day of inspection. Larkins and Seastrole share the same laundry room outside which has two washing machines and one dryer. The wall surfaces of the laundry area are washable and the floor finish non permeable. All staff have received training in infection control and certificates were available for inspection. Seastrole D55 S3954 Seastrole V230574 010605 Stage 4.doc Version 1.30 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35 The home has a well qualified stable staff team to ensure that an effective, detailed therapeutic programme is delivered to service users, meeting their individual and collective needs. EVIDENCE: Records indicated that staff induction occurs within the first 6 weeks of employment and topics covered include equal opportunities and antidiscriminatory practice. The registered provider has fully embraced TOPPS recommendations and has a dedicated training budget and individual training and development assessment portfolios for all members of staff. Three were examined by the inspector on this occasion. In addition a training needs assessment for the staff team as a whole has been conducted. A minimum of 5 paid training and development days is stated in staff’s contract of employment and is achieved. The registered provider stated that two members of staff are working towards NVQ 3 and one towards NVQ 2. Care plans evidence that service users’ individual and joint needs are met by the current staff group. Service users spoken with thought that staff were “well trained in the field of addiction”. One commented that “staff here are very supportive, can’t do enough for you”. Another said that “staff are always around and they know what they are talking about”. Seastrole D55 S3954 Seastrole V230574 010605 Stage 4.doc Version 1.30 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39,42. Service users are given the opportunity to make their views known and to feel they have some input into what happens in the home. This ensures that service develops in the best interests of service users. The health, safety and welfare of service users and staff are protected by suitable policies, procedures and practices at the home. This means that they can be confident of management support and guidance whilst living or working there. EVIDENCE: The opinion of service users receiving treatment at Seastrole is important to the registered provider and her team. Records evidenced that community meetings are held once a week and that they give service users the opportunity to offer suggestions about particular issues. Service users spoken with stated that they meet as a group after dinner each evening and an appointed “House Leader” meets with one of the counsellors to feedback the issues discussed at that meeting. The registered provider stated that all issues raised in this way are dealt with immediately and service users confirmed this. Seastrole D55 S3954 Seastrole V230574 010605 Stage 4.doc Version 1.30 Page 23 A more formalised quality assurance and quality monitoring system based on seeking the views of service users exists at Seastrole. On this occasion the inspector examined the client satisfaction questionnaire that was completed by service users on 12th May. Questions targetted different areas of the treatment programme and service users indicated overall satisfaction with the programme on offer. A task analysis sheet is used to collate the information gathered and results are fed back to service users in group meetings or at mealtimes. The registered provider’s role in the home is very “hands on” every day, there are therefore, no monthly registered provider reports. A service users spoken with said “the best thing about this home is that I feel safe and supported”. Another said “we all learn how to get along together, it’s a very caring place”. On this occasion the inspector examined three staff files to view certificates relating to Health & Safety trianing. Files were well maintained with certificates available for inspection. The three staff had undertaken Health & Safety training, first aid and basic food hygeine, moving and handling training and training in infection control. The home’s gas and electrical certificates were valid, and the portable appliances were tested in March 2005. The home has a record for the maintenance of electrical equipment and laundry machinery. Fridge and freezer temperatures were recorded daily as was the water temperature at the home. Safety regulators have been fitted to the bath taps so that water is approximately 43 degrees at all times. Water tank temperatures are also recorded once a month and these temperatures evidence 62 degrees sufficient to prevent Legionella Disease. Mrs Parry provided a water test report evidencing that the water stored in the tank at Seastrole, showed no species of the Legionella bacteria when tested in December 2004. All rooms above ground level had windows with restrictors fitted to them. There have been no occurences under RIDDOR regulations since the last inspection. Fire records which included staff fire training and drills were examined by the inspector and found to be well maintained. Seastrole D55 S3954 Seastrole V230574 010605 Stage 4.doc Version 1.30 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 4 x x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x x 3 Standard No 11 12 13 14 15 16 17 3 x 3 x 3 x 3 Standard No 31 32 33 34 35 36 Score x x x x 4 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Seastrole Score 3 4 3 x Standard No 37 38 39 40 41 42 43 Score x x 3 x x 3 x D55 S3954 Seastrole V230574 010605 Stage 4.doc Version 1.30 Page 25 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 24 Regulation 23 Requirement The registered provider must ensure that one bedroom is decorated and a chest of drawers replaced. Timescale for action 31/10/05 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. Refer to Standard Good Practice Recommendations Seastrole D55 S3954 Seastrole V230574 010605 Stage 4.doc Version 1.30 Page 26 Commission for Social Care Inspection Unit 4, New Fields Business Park Stinsford Road Poole Dorset BH17 0NF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Seastrole D55 S3954 Seastrole V230574 010605 Stage 4.doc Version 1.30 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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