Inspection on 04/05/05 for St Laurence

This inspection was carried out on 4th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

St Laurence 07/06/07

St Laurence 27/04/06

St Laurence 06/09/05

St Laurence 04/10/04

St Laurence 24/05/04

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

CARE HOME ADULTS 18-65 St Laurence 33 Tower Road West St Leonards-on-sea East Sussex TN38 0RJ Lead Inspector Jason Denny Unannounced 4 May 2005 09:45 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. St Laurence H59-H10 S21222 St Laurence V217185 040505 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service St Laurence Address 33 Tower Road West St Leonards-on-sea East Sussex TN38 0RJ 01424 438262 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) Communitas Limited Miss Kelly-Jane Godden Care Home 7 Category(ies) of Learning disability (LD) 7 registration, with number of places St Laurence H59-H10 S21222 St Laurence V217185 040505 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: 1. Residents must be aged between eighteen (18) and sixty-five (65) years on admission 2. The maximum number of residents to be accommodated is seven (7) 3. Residents with a learning disability only to be accommodated Date of last inspection 4 October 2004 Brief Description of the Service: St Laurence is located in a residential area of St Leonards–on-Sea. The home is close to local transport and amenities. The seafront is within two miles of the home. The home is large detached property with spacious grounds. The garden has undergone redevelopment over the last year and is spacious and well equipped. The home currently provides services for four people with high dependency needs. The home is registered to provide services for seven people in line with its statement of purpose. All residents have a single bedroom some of which are double-sized. There is range of communal areas and sufficient bathroom and toilet facilities throughout. The home has its own mini-bus type vehicle. The Organisation provides a day centre managed by Communitas which some residents occasionally access. St Laurence H59-H10 S21222 St Laurence V217185 040505 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an Unannounced routine inspection [first of two planned before April1st 2006], which took place between 9.50am and 2.50pm. The Inspection found that of the 23 National Minimum Standards inspected, that 14 had been fully met. The focus of the inspection was on seeing how the newest resident was settling in along with looking at progress with another relatively new resident. The inspector spoke with both residents and observed the other resident in the home on that day. The inspector had an extended discussion with 2 staff, the home manager, and the organisation’s operations manager. Part of this discussion was around gathering views on how the newest resident had settled in to the home. Records of unreported incidents in the home were inspected, along with care-plans and other information relating to the two newest residents. The inspector toured all communal areas of the home, including the kitchen. Food stocks were examined. Health and safety records were examined. A record of complaints was inspected. What the service does well: What has improved since the last inspection? The home has replaced carpets on the ground floor hallway area, which has created a homely and modern feel. A new conservatory area has been built onto one of the lounge areas and is now waiting flooring in order to be usable. Additional lounge chairs and fitness equipment has been installed in one of the 2 large lounges. The service continues to focus on staff training. All parties have signed residents’ contacts/agreements. Monthly inspections by the organisation [Section 26 visits] are now carried out by one suitable person, St Laurence H59-H10 S21222 St Laurence V217185 040505 Stage 4.doc Version 1.20 Page 6 which has made things clearer. This also ensures that the manager’s have more time to focus on their homes by freeing up 2 days extra per month. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. St Laurence H59-H10 S21222 St Laurence V217185 040505 Stage 4.doc Version 1.20 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 St Laurence H59-H10 S21222 St Laurence V217185 040505 Stage 4.doc Version 1.20 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) 2,4 & 5 Assessment information in relation residents was of a good standard. The home ensures that prospective new residents have trial visits to ensure they are making an informed choice and to ensure that existing residents have a chance to meet them and pass a view. Residents contracts/agreements are well written, explained, and agreed by all, before a permanent place is offered. Although the newest resident was admitted in line with the home’s statement of purpose he has differing needs to other residents and it is not clear whether his needs are compatible with others. The manager has therefore been asked to reassess this resident and send a report to the Commission. EVIDENCE: The home was found to be acting in accordance with its own Statement of Purpose by ensuring that trial visits are undertaken by prospective new residents and that a full assessment is carried out involving all parties before a decision is made to offer a place in the home. This decision is also based on assessing compatibility with exiting residents. The most recently admitted resident was found to have full assessment information and was found to have visited the home before deciding to move in. The resident, staff, and records confirmed this. The inspector found that another possible new resident has had 3 night stay in the home, a full assessment and is in process of going through a contract before a place is offered. Residents spoken with confirmed that they had met this prospective new resident. The home manager has St Laurence H59-H10 S21222 St Laurence V217185 040505 Stage 4.doc Version 1.20 Page 9 further explored to ensure that this person fits the homes purpose and registration category of learning disability. The newest resident confirmed in discussions that he saw himself as a “helper” to other residents as opposed to being their peers. Staff interviewed confirmed that the resident related better to staff and but generally only took advice from the manager which created a difficulty when she was not there. The resident informed the inspector of a number of anxieties relating to a new resident who he had met on a trial visit and believed he was looking after. This resident expressed a range of differing views to staff, the manager, the inspector and those shown in records. It was therefore difficult to fully evidence what his views are. A reassessment of his needs was requested due a range of incidents of throwing items which have hit staff such as plates, and assaulting another more vulnerable resident. This resident kicked doors and made a range of noise throughout the inspection, along with throwing a cup when confronting a staff person, who whilst standing near the inspector was attempting to offer advice around toilet cleaning. The resident concerned made a number of comments, which questioned the suitability of the home to meet his needs. He indicated that he did not understand the purpose of the home and saw himself unnecessarily restricted although he realised that he was at risk if he went out alone. He said that the homes approach to him was not calming him down and that he wanted medication. Overall he said that he “was not understood” and would continue to be violent and aggressive when staff “did not let him do his job”. He referred to throwing plates at people because he was stopped by staff from cooking a recent barbecue. This was confirmed in an incident report of 27.04.05, where a plate hit a staff member in the head. The violent way in which the resident communicates his feelings and puts demands on staff was seen to be different from two other residents who one staff member said had become “marginalised” due to the attention needed for the new resident. Another resident informed the inspector “I want to move, I am bored and upset here, Hastings is too small, I cannot get a job”. It was not clear what was causing him to be upset. The manager and staff confirmed that he is often up and down, and along with the newest resident is more difficult when he is not occupied. St Laurence H59-H10 S21222 St Laurence V217185 040505 Stage 4.doc Version 1.20 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 Care-Plans were found to contain good information subject to regular review with all relevant people. Care-plans showed evidence of being put into action. The care-plans were found to be well organised. Staff showed a good understanding of guidelines especially in relation to the newest resident. Resident’s benefit from independent advocacy, which operates on their behalf. Risk assessments were found to be relevant and thorough. EVIDENCE: The Inspector examined 2 Care plans which were found to be accessible, clear and frequently reviewed as shown in one plan which had been reviewed with relevant specialists two months in to the new placement [08.03.05]. This review involved the resident, his advocate, a range of specialists such as a psychiatrist and his care-manager. The review confirmed that the placement was going well. The care-plan also reflected the full range of needs and the issues, which the person presents, including a useful history. The care-plan and assessment also supported the inspector’s initial views of the resident through their discussions together. The resident also has a weekly counselling session. A number of staff, around half, [5] were found to have signed this care-plan. St Laurence H59-H10 S21222 St Laurence V217185 040505 Stage 4.doc Version 1.20 Page 11 Staff were found to be involved in the review of care-plans, and confirmed understanding of the newest residents plan. Staff also confirmed that this information was easy to follow despite the number of behavioural guidelines. Risk assessments were found to be full and regularly reviewed. The newest resident had a full missing person’s procedure including a profile and recent photograph. The key worker/ manager for the new resident showed a good knowledge of the plan and the issues presented by the resident. The inspector found evidence in care-plans, minutes of meetings and contracts, of the continuous involvement of the advocacy service, which works alongside the home on behalf of residents. St Laurence H59-H10 S21222 St Laurence V217185 040505 Stage 4.doc Version 1.20 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,15,16 & 17 Meaningful Activities for all residents is not taking place with further work needed especially for those residents who are more able. Some residents require further educational input to assist with the development of skills such as communication. The majority of activities on offer are of a leisure variety. Two residents indicated that they were bored with their current range of activities leaving a high amount of unoccupied time on their hands. Full structured routines need to be reviewed for all residents based on informed choice and to ensure that full opportunities are explored to meet assessed needs. Meal arrangements were good. EVIDENCE: The inspector observed one resident having breakfast at 11am who then spent some time standing in the garden. Another resident was at the day centre. The two more able residents spent the duration of the inspection in the home largely unoccupied. One of these residents was at times cleaning toilets and polishing largely without support although it was clear that he did not have the full skills to do this effectively. This was evidenced in his removal of paper St Laurence H59-H10 S21222 St Laurence V217185 040505 Stage 4.doc Version 1.20 Page 13 towels from toilets and his heavy use of polish. He eventually became verbally abusive and threw a cup of tea when he unsuccessfully demanded a toilet duck. The staff were concerned that he would use the whole amount as he has done in the past. The resident described his cleaning role as a “punishment” without explaining why he took this view. He confirmed that he wanted to do domestic tasks, as there were limited opportunities apart from the gym and training for a marathon. He confirmed an interest in college and work opportunities but was not clear when this would happen. The manager confirmed plans to look at this from September. The resident indicated that he was far more active in his previous placement such as regular football and visiting a day centre. It was not clear that the resident had not moved into an active daily routine. Another resident stated that he was “bored” he was observed throughout the inspection to be in the home as he has been on 2 previous visits, unoccupied except for occasional smoking. The resident referred to his weekly plan which largely involved leisure activities each day such as bowling on the afternoon of the inspection. He was unsure what happened on a Tuesday and described Mondays as drawing out money having breakfast and going to the pub in the evening. The manager and operations manager discussed with the inspector plans to increase activities and ensure that all staff are motivated to support residents access a fulfilling lifestyle. It was evident that the new resident with good verbal skills, who spent around 2 hours of the inspection regularly kicking door frames and doors needs help with communication skills in relation to dealing with problems. The management of the home indicated that there are written routines in place but accepted that these need to be followed and more fully developed. The inspector found that the home had a range of fresh fruit, and vegetables along with frozen food including meats. The home maintains a menu based on residents preferences and needs. St Laurence H59-H10 S21222 St Laurence V217185 040505 Stage 4.doc Version 1.20 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 & 19 The inspector found a range of evidence to indicate that the health needs of residents were being promptly and fully addressed. Staff were observed to treat residents with sensitivity and respect. There is a low level of admittances to Accident and Emergency. EVIDENCE: The Inspector found that epilepsy training had been organised for all staff in light of a prospective new resident due to move into the home several weeks after the inspection. Staff also confirmed that they had seen an initial assessment on this new prospective resident and were aware of how health needs would be met. Care-plans inspected indicated the full range of health needs and how they were being met and reviewed. There was found to be one admittance to accident and emergency over the last year. Dental, eye, and hearing check-ups were found to be on schedule. Medication was found to be reviewed in accordance with the standard. St Laurence H59-H10 S21222 St Laurence V217185 040505 Stage 4.doc Version 1.20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 & 23 The home needs to improve the level of detail and clarity in its complaint file in accordance with the standard and the home’s own policy and procedure. Staff continue to demonstrate an sound understanding on how to prevent and report abuse and continue to benefit from adult protection training. Staff were found to be aware of the homes complaints recording policy and procedure. All staff follow a consistent approach when dealing with residents distress. The accounting practices of the home in relation to the management of residents personal finances was found to have improved in terms of accountability. EVIDENCE: Two complaints made by a particular resident over the last year were found in the complaints file undated. One of these complaints had been described as being withdrawn although the complainant had not confirmed this on the file. The other complaint indicated that a letter had been sent to the complainant resolving the matter although this was not found in the complaint file. This complaint related to unnamed resident, possibly the newest resident. The inspector spoke to the resident concerned who confirmed that both issues were sorted, although he claims that there was still an unrelated issue around rats in the shed. All staff working in the home have received formal training in adult protection and prevention of abuse. Staff who have been interviewed across several inspections continue to demonstrate a full and sound understanding of all the issues involved, including whistle blowing and who to report concerns too. The home has a detailed complaint policy and form for reporting concerns. The procedure is also written in a way more understanding to those with a learning disability. The organisation have now acted on a long standing recommendation from both the Commission and Social Services that all staff receive the same and appropriate training in dealing with challenging or St Laurence H59-H10 S21222 St Laurence V217185 040505 Stage 4.doc Version 1.20 Page 16 aggressive behaviour in order to safeguard residents and themselves. The organisation have also been advised to continue to ensure that such training approaches [SCIP] are clearly indicated in the residents care-plan, and the homes statement of purpose to avoid any confusion. Several Section 26 monthly reports [January 2005 and March 2005] have repeatedly stated that an accurate running total of residents monies held by the home was not being maintained. This is additionally concerning as there have also been historical concerns about security arrangements around this area. On the day of the Inspection the manager stated that this had now been sorted with all staff maintaining an up to date balance of resident monies managed by the home. This is also checked at each shift changeover. St Laurence H59-H10 S21222 St Laurence V217185 040505 Stage 4.doc Version 1.20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,26,27 & 30 The home continues to explore ways of making the environment more homely and benefits from some ongoing investment. The rear garden is well maintained but not wheelchair accessible. The entrance area to the home creates a poor impression. The home needs to improve its cleaning practices. Some maintenance jobs such as a toilet seat and a missing lounge door were found to need urgent attention. EVIDENCE: The foyer entrance to the home was found to be dirty by a combination of litter and ash. A shoulder height mounted ashtray directly confronts a caller to the homes front entrance. The home has installed on ground floor corridor, modern homely carpets. A New Conservatory was found to have been built but lacks a suitable floor and is currently out of use, which has been the case for several months. The two lounges are large and well-equipped one had 7 chairs plus exercise machines. A downstairs toilet was found to have no seat or any notice. There were no handrying facilities. The manager of the home said this was due to the new resident taking the paper towels away. This was also the case with another toilet, which the inspector also used. The floor of one bathroom/toilet was dirty and wet. No residents have lockable storage space in their rooms. The St Laurence H59-H10 S21222 St Laurence V217185 040505 Stage 4.doc Version 1.20 Page 18 operations manager explained that she had a plan to rectify this. Staff indicated that the new resident had kicked down a lounge door. One staff member said that she was concerned that a long established resident was starting to copy this behaviour. The new resident was observed to be cleaning toilets but was resistant to advice and due to staff wanting to avoid confrontation and incidents, was doing this largely unsupervised. The resident confirmed some awareness of infection control but in practice was ignoring such advice. He was on one occasion observed to be cleaning toilets without wearing gloves. St Laurence H59-H10 S21222 St Laurence V217185 040505 Stage 4.doc Version 1.20 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35 Training arrangements were judged to meet the standard and staff’s needs and expectations. The organisation outside the home showed an understanding of some of the issues in the home. This standard was not exceeded on this occasion due to some staff still waiting to start NVQ’s and difficulties with managing a particular resident. EVIDENCE: Staff interviewed including newer staff remarked positively, on the amount and range of training now being offered. One member of staff spoken with said that she felt well supported in her role and will shortly be enrolled on a NVQ 2, which she had hoped to start last year. She had completed all other training including SCIP [Challenging behaviour management training] during her first 6 months of employment and had already received 2 appraisals during her first year. She indicated that she was booked to re do TOPSS[ National Government set training]. She confirmed that a team-building day was booked the day after the inspection and which would also help the team support the new resident. The operations manager confirmed that this training was being organised to assist consistency in the staff team. St Laurence H59-H10 S21222 St Laurence V217185 040505 Stage 4.doc Version 1.20 Page 20 Inductions for new staff now take place at head office before the applicant starts work in the home. This induction has been extended from one week to three weeks. This induction covers TOPSS, all mandatory training such as Moving and handling, food hygiene and First aid, and the foundational course level 2 in Care Practice, which leads to an NVQ 2. A basic introduction to the company’s philosophy of care is also included, leading to the in-house structured written induction found in each home. The new manager has introduced structured in-house inductions, which are signed by the supervisor and inductee. St Laurence H59-H10 S21222 St Laurence V217185 040505 Stage 4.doc Version 1.20 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 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) 37,39 & 42 The management of the home was again found to be competent and attentive. One shortfall in the managing organisation’s quality assurance system needs to be rectified to promote accountability to ensure that the Commission receive timelier reports of the organisation’s inspections. The manager has neglected to inform the Commission of significant incidents in the home, which have affected the welfare of residents and staff. The home is therefore advised to demonstrate a fuller level of accountability. Most health and safety areas were found to be met except food storage. EVIDENCE: Section 26 monthly reports of inspections of the home by the organisation are still not being sent to the Commission on a monthly or timely basis. The last report to be sent to the Commission [April 26] was of a visit, which had occurred a full month earlier [March 26]. The manager confirmed that she also received her copy of the report at the same time as the Commission. The organisation has decided that 1 person will now carry out these visits and it is hoped that this will benefit the process. The home has introduced a St Laurence H59-H10 S21222 St Laurence V217185 040505 Stage 4.doc Version 1.20 Page 22 quality assurance system based on residents or their representatives views. Some views of residents have been placed in the home’s guide. A number of serious incidents involving a particular resident spanning several weeks had not been reported to the Commission in either a timely, or any other manner. The manager was advised to personally supervise this and ensure that such incidents are reported within at least 48 hours. The inspector examined the homes Incident file and found that some of these incidents have involved crockery hitting staff and a one resident being “slapped in the face”. The manager was informed that these were significant events and that if she was confused about whether to report that she should urge on the side of over reporting. This is particularly relevant in the case of the newest resident who requires close monitoring a situation, which the Commission will also require up to date and regular information on. It was evident that most incidents involving the new resident occur when he is being advised or when he dislikes behaviour of other residents. The manager stated that she felt that the new resident had settled in well a statement contradicted by the records, discussions with staff and the resident, along with the inspector’s observations. The new manager has been in post since July 2003 and has begun a NVQ Level 4 in Management with the registered managers award. The manager has held registration in a previous managerial position for 8 years, and has a management qualification from the leisure industry. The Inspector found most food correctly stored and labelled except a plate of cooked chicken placed in the fridge with no covering or labelling to indicate date of cooking or expiry. St Laurence H59-H10 S21222 St Laurence V217185 040505 Stage 4.doc Version 1.20 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. Where there is no score against a standard it has not been looked at during this inspection. 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 3 x 3 3 Standard No 22 23 ENVIRONMENT Score 2 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 2 2 x x 1 Standard No 11 12 13 14 15 16 17 x 2 3 x 3 2 3 Standard No 31 32 33 34 35 36 Score x x x x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 St Laurence Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score 3 x 2 x x 1 x H59-H10 S21222 St Laurence V217185 040505 Stage 4.doc Version 1.20 Page 24 Are there any outstanding requirements from the last inspection? Yes 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 2 Regulation 14[d]&[2] [a][b] Requirement That the registered manager must carry out an reassessmentent on a particular service user and confirm in writing to the Commission the suitability of the placement. That each service user must have regular, and structured meangingfull actitvities on a daily basis based on preferences, full consultation, and consideration of all assessed needs, including the opportunity to develop community, training, and educational skills. That the homes complaint file must contain a clear record of complaints made, in accordance with the standard. That a toilet seat must be repaired and thereafter kept in a good state of repair. That the home is kept clean with effective systems to ensure both this and reduce the risk and spread of infection by such measures as providing handdrying facilities in toilets and bathrooms. That section 26 reports of monthly visits must be carried Timescale for action 04.07.05 2. 12 16[m][n] 04.09.05 3. 22 17[2] Schedule 4 23[2][b] 13[4] 04.06.05 4. 5. 27 30 04.06.05 04.06.05 6. 39 26 Timescale Extension Page 25 St Laurence H59-H10 S21222 St Laurence V217185 040505 Stage 4.doc Version 1.20 7. 42 37[1] out by a competent person and sent to the Commission without delay on a monthly basis. [Requirement from the last 5 Inspections. Requirement first made August 2003.] That the registered person must notify the Commission without delay, of any significant event described in the regulation, such as accidents, injuries, incidents of disease and visits to Accident and Emergency, or any event which affects the welfare of service users. 04.06.05 Immediate 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 16 Good Practice Recommendations That each service user has clear, predictable, and structured routines based on assessed needs, for the aim of promoting independence and ensuring a meaningful day. That these routines are followed in practice. That each service user has lockable storage space in their rooms which is only accessible to them. That food is correctly stored and labelled. 2. 3. 26 42 St Laurence H59-H10 S21222 St Laurence V217185 040505 Stage 4.doc Version 1.20 Page 26 Commission for Social Care Inspection Ivy House, 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 St Laurence H59-H10 S21222 St Laurence V217185 040505 Stage 4.doc Version 1.20 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. 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