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Inspection on 16/04/08 for Seeleys House

Also see our care home review for Seeleys House for more information

This inspection was carried out on 16th April 2008.

CSCI found this care home to be providing an Adequate service.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Seeleys House Seeleys House Campbell Drive Knotty Green Beaconsfield Buckinghamshire HP9 1TF     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Date: 1     7 0 4 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 30 Information about the care home Name of care home: Address: Seeleys House Seeleys House Campbell Drive Knotty Green Beaconsfield Buckinghamshire HP9 1TF 01494 670902 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable): Type of registration: Number of places registered: Buckinghamshire County Council Mrs Wendy S Rutland care home 12 Conditions of registration: Category(ies) : People with Learning disability Additional conditions: The maximum number of service users who can be accommodated is: 12 The registered person may provide the following category 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: Learning disability - LD Number of places (if applicable): 0 Date of last inspection Brief description of the care home Seeleys House is situated in Beaconsfield and provides respite care for up to twelve people with learning disabilities. It is located in a residential area outside of the town and is linked to a day service which operates Monday to Friday. A range of shops, cafes, bars and banking facilities are about a mile away in the town centre and there are bus links to neighbouring towns and London and train links to London and the rest of the rail network. The building provides accommodation on ground floor level with twelve single bedrooms with hand basins. There are two adapted bathrooms to meet the needs of people with disabilities and spacious communal areas. The service has its own transport to help people access the community. Fees for the service vary Care Homes for Adults (18-65 years) Page 4 of 30 depending on people’s financial circumstances and are subject to assessment by the local authority. Care Homes for Adults (18-65 years) Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Individual needs and choices Lifestyle Personal and healthcare support peterchart Concerns, complaints and protection Environment Staffing Conduct and management of the home Poor Adequate Good Excellent How we did our inspection: This unannounced key inspection was conducted over the course of two days by Chris Schwarz and covered all of the key National Minimum Standards for younger adults. The last key inspection of the service was carried out on 12th April 2007. Prior to this visit, a detailed self-assessment questionnaire was sent to the manager for completion and comment cards were sent to a selection of people who use the service, relatives and visiting professionals. Any replies that were received have helped to form judgements about the service. Information received by the Commission since the last inspection was also taken into account. The inspection consisted of discussion with the manager and other staff, opportunities to meet with people using the service, examination of some of the home’s required Care Homes for Adults (18-65 years) Page 6 of 30 records, observation of practice and a tour of the premises. A key theme of the visit was how effectively the service meets needs arising from equality and diversity. Feedback on the inspection findings and areas needing improvement was given to the manager at the end of the inspection. The manager, staff and people who use the service are thanked for their co-operation and hospitality during this unannounced visit. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk.You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line – 0870 240 7535. Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection care home Page 9 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service are assessed by the local authority prior to admission although this information is not always up-to-date for subsequent visits, which could mean that accurate records of care requirements are not consistently in place. Evidence: A statement of purpose and service users guide were in place for Seeleys House. Both were in the process of being reviewed by the manager with a completion target of the end of August this year. The manager was reminded to make sure that these documents (and any policies or procedures which contain the contact details of the Commission) are updated to reflected the Regional Contact Team in Maidstone, Kent. A Widgit version of the service users guide had been written but it was noticed that staff had used the computer to translate every word into a symbol, making the guide too concentrated with symbols, some not making sense such as a laundry basket symbol to explain the word ‘washing’ in relation to a sink in each bedroom for washing in, and a winding road to explain ‘way’ in ‘dignified way’. It is recommended that as Care Homes for Adults (18-65 years) Page 10 of 30 part of the updating of the service users guide a more accessible version is produced, perhaps making use of the digital camera that the service now has and simple, very short sections of text to describe what is on offer so that service users can make use of it. People using the service are referred by the local authority and their needs are assessed by care managers. Copies of assessments were contained on people’s files and it was noticed that these were not always up-to-date, such as an assessment dated October 2006 for a service user coming in in January 2008. The home did not have its own written assessment documentation although staff confirmed that they do visit prospective users at home or in day services. A recommendation is made for the service to record its own care needs assessments to supplement information provided by the local authority. Records were being kept of tea visits undertaken by prospective service users and how they had got on during their time at the home. During observation of staff practice, a considerable amount of time was spent on the first day responding to a potential emergency admission which did not materialise as a family member intervened to provide care. The assessment provided to the service in case the person came in was not up-to-date (March 2007). Staff at the service are affected by the quality of the assessments they receive from the local authority, as this forms the basis of their care plans, and have no control over emergency admissions. Contact will be made with the responsible individual for the service to discuss these matters. People who completed surveys confirmed that they had been invited for tea visits before they started using the service and three service users said they had been consulted about using it. Two said they had received enough information about the service. A care manager said that the service responded well to emergency situations and was good at meeting and greeting prospective users. care home Page 11 of 30 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is good regard for the diverse needs of the people living at the home and their requirements related to their disabilities, lifestyle choices and personal preferences are sought, recorded and met by the staff team, respecting their rights, choices and individuality. Evidence: Care plan files were in place for each person using the service which followed on from the assessments carried out by the local authority. A sample of three files was looked at, each containing a summary of care needs which included how the person communicates, any medication they require, mobility and dietary needs. In two files the summary had been completed to good effect, in the other only a few of the sections had been completed. The care plans noted details such as people’s preferred name, doctor, next of kin and emergency contact details, activities the person likes, Care Homes for Adults (18-65 years) Page 12 of 30 dietary needs and how they manage mail and money. The main purpose of the placement was noted and any known risks. Information on people’s cultural and religious needs was taken into account and put into practice, such as provision of halal meat and showering those service users whose religious needs required this. Families had contributed to information on care plans, such as the health care elements detailing how personal support is to be carried out, and had signed and dated the documents. In discussion with the manager, it was suggested that care plans for those people who have epilepsy should consistently provide enough information about the type and nature of seizures such as a description of what the person’s seizures look like and any factors that staff need to take into account, such as the likelihood of the person falling to the floor during a seizure or running whilst post ictal. A requirement is made to this effect. For one person who had just been diagnosed with epilepsy, staff will need to make sure that the care plan and health care information are updated before the next visit and that written guidance on the use of rectal diazepam is obtained from the doctor or consultant before she comes in. Staff were observed offering choices to people using the service, such as what type of sandwich they would like for lunch, options of drinks and type of activity to engage in. None of the people using the service at the time of this inspection managed their own money – small amounts of cash had been brought in by relatives for things such as day care attendance and incidental costs, with staff looking after this in the safe and keeping individual transaction records of expenditure. Records of the provider’s visits reflected that an advocate was involved with one person. Risk assessments were in place on each of the files looked at, and were all up-to-date. Assessments covered areas such as using transport, assisting with feeding, moving and handling, risk of absconding and choking. People who completed surveys said that they ‘always’ or ‘usually’ get enough information to help make decisions and that their needs were met by the service. Relatives said that they are kept up-to-date with important issues. People considered that needs arising from equality and diversity were ‘always’ or ‘usually’ met. One person added ‘the clients are always happy – they try to have friends in together’ and another commented ‘I am very happy with the care my daughter receives at Seeleys House and she always asks when she is going again, so I think that says it all.’ care home Page 13 of 30 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Activities are available to people using the service to provide them with stimulation and contact with the community is supported to maintain social links. Food is well prepared and takes into account people’s preferences and cultural choices to make sure that nutritional needs are met. Evidence: People using the service attend day services during the week therefore the home is normally empty of service users until people come in around 4.00 pm. One person who usually attends college during the week was at the home due to the Easter holidays. Since the last inspection, there has been improvement to activities and a diary was being kept of things that people had been involved in such as going to Care Homes for Adults (18-65 years) Page 14 of 30 Gateway Club, baking, painting, gentle exercises, karaoke, badminton, walks, using the local pub, trips out and watching DVDs and videos. Staff can also make use of the day service resources linked to the home. Over Easter there had been an Easter egg hunt and people had been helped to make bonnets. The service had its own transport and four approved drivers to help service users access the community. The only matter raised with the manager was that the service user who was at the home during the day could perhaps have been more engaged in activities or taken out, given the number of staff who were on duty. People using the service do not usually receive visitors, due to the nature of the service provided. Their preferred form of address is noted on their care plan files; if ambulant they were seen to choose whether to be alone or with other people. Staff were seen taking an interest in service users, such as with one person who had brought some family photographs in which staff looked at with the service user and asked them questions about who the people were. Menus followed a four week plan with a range of meals offered to people using the service. An agency cook was being used and he said that he is given sufficient information about people’s needs, such as whether halal meat in required and the type of plate that each person needs, with this information recorded on a daily chef’s plan. Staff had an information sheet to refer to regarding dietary requirements and preferences of different cultural groups. A home made beef and mushroom pie was been prepared during the inspection with fresh vegetables to accompany and a fruit flan to follow. Most people who completed surveys said when they stay at the service they can do what they want during the day, evening and at weekends. One person added that they ‘would like to visit the shops in a wheelchair’ and someone said ‘I do not like the food – sometimes I would like to be asked which are my favourite foods.’ care home Page 15 of 30 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care needs of people living at the home are well met, promoting health and well-being. Some adjustments are needed to practice to ensure that people receive medication in a safe and consistent manner. Evidence: Personal care needs were noted in health care plans which covered the type of learning disability the person had, their communication needs, moving and handling and help or support required to assist with daily living tasks. Information on people’s cultural and religious needs was taken into account and put into practice, such as showering those service users whose religious needs required this. Where female service users needed to be assisted only by female staff, either due to preference or religious beliefs, rotas were arranged to make sure that there were sufficient female staff on duty and that these requirements were met. Staff were being allocated to work with specific service users during the day and this was recorded on a shift planner, helping to make sure that people using the service received continuity. Care Homes for Adults (18-65 years) Page 16 of 30 Personal care was carried out in private and staff were seen making use of personal protective items, such as disposable gloves and hand gel, to prevent cross infection. Staff responded promptly to a service user who said he could not hear properly and replaced his hearing aid battery within a few minutes. The service has two adapted bathrooms. A recent occupational therapy assessment has taken place which has highlighted a need for ceiling tracking and some reconfiguration, which the manager said would take place. Staff had access to guidance on medication practice although this did not cover the service’s recording of medication. The manager advised that work has already taken place to address this and further guidance could be expected in May this year. There was a medication trolley in the office, chained to the wall and the key kept on a senior member of staff. Only one person’s medicines were contained within the trolley. A look at recent medication administration records showed that staff are appropriately recording medication given to service users and a controlled drugs register was in place for use when necessary. No controlled medicines were being used at the service at the time of this visit. It was noticed that the secondary compartment within the trolley, which was where staff would store controlled drugs, had not been secured to the trolley and could be lifted out. It also had a label on it saying that it had a dual purpose – storage of controlled drugs and medication to be disposed of. This does not follow safe practice in handling medicines and a requirement is made for a separate medication disposal facility to be set up and another for the secondary compartment for the storage of controlled drugs to be made secure within the trolley or elsewhere. A care manager said that people’s health care needs are ‘always’ properly monitored and attended to by care staff and that service users are ‘usually’ supported to manage their medication if able to and subject to risk assessment. The person also said that privacy and dignity are ‘always’ respected by staff. A member of staff said ‘we are not always notified of medication changes prior to clients coming to stay which can lead to last minute calls to GPs etc.’ care home Page 17 of 30 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Complaints are effectively managed within the service to listen to the views of people who use the service and their representatives. Inconsistencies with practice in relation to adult protection could place people at risk. Evidence: The service had a complaints procedure in place to listen to views of people and their representatives. This corporate complaints procedure was available in a range of languages and formats including an audio tape version. The complaints log showed that there had been eight compliments about quality of care and three complaints. Each of the complaints had been responded to appropriately. People who completed surveys said they knew how to make a complaint and all said that the service ‘always’ responds appropriately when complaints are made. No one had made any complaints directly to the Commission. There were adult protection/safeguarding procedures in place. Four new adult protection/safeguarding issues had been recorded. Appropriate action had been taken in response to these incidents when they became evident although only one had been notified to the Commission, which is a serious omission. A requirement is made to ensure that any safeguarding issues are reported to the Commission within 24 hours of occurrence. Training for staff had taken place shortly before the inspection although Care Homes for Adults (18-65 years) Page 18 of 30 it was concerning to see from training records that one person who started work in 2006 had not undertaken training until this month and another person last attended adult protection training in 2000. During observation of practice, a member of staff was seen cradling a service user, overstepping acceptable boundaries. The behaviour was not challenged by a more senior member of staff who was also present in the room. care home Page 19 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is clean and offers single room accommodation for people using the service to promote privacy. Improvements are planned to décor, furnishings and bathrooms to brighten and freshen areas and provide better facilities for people with disabilities. Evidence: The premises are located in a quiet residential road in Beaconsfield. There is no direct public transport link, the railway station, bus links, shops and amenities are in the town which is about a mile away. The home has ramped access and all parts of the accommodation are on level ground. There are twelve single bedrooms, varying is size, each with a hand basin. Service users have a lounge and large dining room, there are two adapted bathrooms and adapted toilet facilities, a kitchen, laundry and staff offices. The home is linked by a corridor to the day service facilities. Improvements are planned to the bathrooms following the occupational therapy assessment, new furniture is being purchased for bedrooms, the lounge and dining room and redecoration is envisaged for bedrooms, the dining room and hallways. Laundry and kitchen areas were clean and in good order. There were no offensive Care Homes for Adults (18-65 years) Page 20 of 30 odours and arrangements were in place for disposal of clinical waste. People who completed surveys said that the home is kept fresh and clean. care home Page 21 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has sufficient staff to meet the needs of people using the service and offers a range of staff training to ensure skills and knowledge are kept up-to-date. Some attention to recruitment is needed to make sure that people using the service are not placed at risk of harm from unscrupulous people. Evidence: People who completed surveys felt that staff ‘always’ or ‘usually’ had the right skills to meet needs and that service users were treated well. Most considered that staff listen and act on what service users say. One person commented ‘I feel they are very caring towards clients. If problems do arise they do their utmost to solve them.’ When asked what the service does well, a relative said ‘taking care of my daughter when I need a break from routine and she loves being there and that gives me such a relief.’ There was comment from a range of sources that the home had to rely on agency staff over the past year to cover vacant posts. Agency staff were included in the rota at the time of the inspection to help cover the equivalent of five full time posts. Recruitment files were looked at for three staff. In two files, all required checks could be evidenced, in the third there was only one reference available - the provider had Care Homes for Adults (18-65 years) Page 22 of 30 commented since the inspection that the second reference is held at County Hall. For agency staff, the home was generally using one agency for care staff and had in place thirteen individual recruitment profiles sent by the agency to confirm that proper checks had been carried out. However, there were four additional staff being used on the rota for whom there were no profiles verifying checks had been undertaken. A Criminal Records Bureau check was in place for a volunteer who is a former member of staff at the home. A requirement is made to ensure that no staff commence at the service until all recruitment checks have been returned and are satisfactory, which includes providing evidence of satisfactory agency staff checks. From surveys, staff felt that training was being given which was relevant to their roles and helped them understand individual needs of service users. There was good uptake of National Vocational Qualification training with 75 of staff already possessing National Vocational Qualification level 2 or above and further staff undertaking it. Training records were looked at. Some tidying of the file is needed to remove certificates from the 1990s and to ensure that the records are accurate with a certificate to verify each course attended. A range of mandatory and specialist courses had been undertaken by the staff team, most up-to-date on mandatory training although there were gaps to food handling and hygiene - training on this was booked for May this year. Comment on adult protection training has been made under the concerns, complaints and adult protection section. In terms of specialist training, fourteen people had attended training run by the National Society for Epilepsy on the administration of rectal diazepam. Seven staff had attended training last year on gastrostomy care. Some staff records showed that they had attended diversity training and epilepsy awareness as well as understanding learning disability. A course on eating and swallowing on the first day of the inspection was described as particularly useful. There was improvement to the frequency of staff supervision to discuss their work and a spreadsheet had been put in place by management to monitor this. Staff said they receive support and discuss how they are working and that communication systems usually work well, one adding ‘we have regular supervision with an allocated team leader where we can voice any problems or worries and hopefully sort it out’. A member of staff said their induction covered everything they needed to know to do the job when they started. care home Page 23 of 30 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management and administration of the home generally promotes continuity and quality of care for the people who live there and ensures that risk is safely managed to reduce the likelihood of injury or harm. Evidence: The home has a permanent manager in place who has obtained the Registered Managers Award and is registered with the Commission. A deputy manager is also in place and she is working towards achieving the Registered Managers Award. The certificate of registration was displayed in the hallway. Monitoring of the service was taking place each month by a representative of the provider with reports of visits available to read. A requirement had been made at the last inspection for a quality assurance system to be developed which takes into account service users’ views and those of their representatives. This had not been done and the requirement is repeated with a fresh timescale. Health and safety was being managed well. Hoists Care Homes for Adults (18-65 years) Page 24 of 30 were being serviced, portable electrical appliances had been serviced at the end of last year and a bronze award for food hygiene had been awarded by an environmental health officer in July last year. Infection control training was booked for the staff team for May this year. The Commission received confirmation from the fire safety officer in May last year that the home had satisfactory fire precautions and a fire risk assessment in place. The only matter raised for the manager’s attention was a trailing extension cable leading from the wall mounted television in the dining room. This needs to be made secure to prevent anyone catching their foot in the wires. care home Page 25 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 26 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 6 12 Care plans are to contain 01/08/2008 more detail of service users’ epilepsy such as descriptions of what seizures look like and risk factors that staff need to be aware of such as likelihood of falling or running away post ictal. This is in order that staff have sufficient information to hand to best meet peoples needs. 2 20 13 The storage of controlled medicines and medicines for disposal are to be kept separate. This is to ensure that the home complies with safe medication practice. 20/05/2008 3 20 13 The secondary compartment 20/05/2008 within the medication trolley is to be secured using bolts. Care Homes for Adults (18-65 years) Page 27 of 30 This is to ensure that controlled medicines are stored in accordance with safe practice. 4 23 37 Adult protection incidents and allegations are to be notified to the Commission within 24 hours of occurrence. This is to ensure that the home complies with its responsibilities to inform the Commission of serious events. 5 34 19 New staff are not to commence working at the service until all recruitment checks have been returned and are satisfactory, which includes providing evidence of satisfactory agency staff checks. This is to make sure that people using the service are not placed at risk of harm. 6 39 24 A quality monitoring system is to be developed which includes the views of people using the service and their representatives. This is to ensure that the home is meeting people’s needs and delivery good quality of care. 01/09/2008 31/05/2008 31/05/2008 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 14 1 The details on any documents or procedures that mention the Commission need to be updated to reflect new contact arrangements located in Maidstone, Kent. A revised version of the service users guide is to be produced which people will be able to understand and make better use of, so that they have information that is accessible to them. The manager is to make sure that pre-admission assessments of prospective service users, carried out by staff at Seeleys House, are recorded in order that there is evidence of them taking place. The extension cable leading from the wall mounted television in the dining room is to be made secure to prevent anyone catching their foot in the wires. 15 1 16 2 17 42 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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