Inspection on 08/11/05 for Stairways

This inspection was carried out on 8th November 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Stairways 20/07/07

Stairways 19/07/06

Stairways 24/05/05

Stairways 23/11/04

Stairways 21/07/04

Stairways 12/12/03

Similar services:

Claremont House

Coopers Mill Ltd

Sun Court Nursing Home

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

15 Bramble Close

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

CARE HOME ADULTS 18-65 Stairways 19 Douglas Road Harpenden Hertfordshire AL5 2EN Lead Inspector Mr Tom Cooper Unannounced Inspection 8th November 2005 4:00 Stairways DS0000019550.V264133.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Stairways DS0000019550.V264133.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Stairways DS0000019550.V264133.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Stairways Address 19 Douglas Road Harpenden Hertfordshire AL5 2EN 01582 460 055 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Harpenden Mencap Society Darren Lelliott Care Home 17 Category(ies) of Learning disability (17), Physical disability (17) registration, with number of places Stairways DS0000019550.V264133.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home may accommodate children and adults with learning disability or physical disability (when associated with learning disability). 24th May 2005 Date of last inspection Brief Description of the Service: Stairways is a care home for seventeen people with a learning disability, who may also have an associated physical disability. This total includes the provision of respite care to four children. The home is a large Edwardian property in Harpenden, divided into four self-contained flats, each with kitchen, lounge, toilet, bathroom and bedrooms. Flat 1 accommodates up to 5 service users with a learning disability; Flat 2 accommodates up to 4 service users with severe learning disability who occasionally display behavioural difficulties and Flat 4 accommodates up to 4 service users with moderate to severe learning disability. The short-term care unit accommodates up to 4 children plus day care for 1 child. This unit comprises a kitchen/dining room, bathroom/toilet, utility room, bathroom, toilet, lounge, playroom and four single bedrooms. There are spacious grounds surrounding the house and car parking for several vehicles at the front. The house is near Harpenden shops and other community amenities and public transport routes to St Albans and Luton are accessible. Stairways DS0000019550.V264133.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the second inspection for the year 2005/6 under the National Minimum Standards for Care Homes for Younger Adults and the Care Homes Regulations 2001. The last inspection was carried out on 24th May 2005. Because the home also operates a separate respite unit for children between 5 and 19 years of age, consistent with the previous inspection reports it is the view of the Commission that the Children’s Homes Regulations 2001 and the National Minimum Standards for Children’s Homes apply to this aspect of the service provision. This is therefore reflected in the text of the report where appropriate. This unannounced inspection took place on a weekday over one afternoon/evening. At the time of the visit there were 13 adults and 3 children in residence. The main focus of the inspection was on talking to service users and staff to obtain their views on the service. Discussions were held with most of the service users present including 2 children, 7 staff and a brief contact with a service user’s relative as well as the assistant manager, who was in charge of the home. Documentation examined included four service users’ care plans, physical intervention and sanctions records, service records for some special equipment, fridge temperature records and medication records in one flat. The inspector visited each of the four units to inspect the facilities provided and viewed approximately ten bedrooms. The inspection indicated that service users were very satisfied with their lives in the home and that their care has been maintained to a good standard by a caring, competent and motivated staff team. What the service does well: All the service users consulted said they liked living in the home and appreciated the opportunities they had to lead stimulating lifestyles that suited them. They also felt the food provided was good and appeared to enjoy the amounts of independence the home affords them. Observations of staff and residents interacting together indicated that there was an excellent rapport between them and even when dealing with some difficult behaviour staff demonstrated a calm and measured approach. Staff dealing with the physically disabled service users were kind, gentle and knowledgeable about the specific personal care needs of individuals and how to meet them. Therefore the home is a pleasant place to live where service users feel they are treated well and any complaints they might make would be sympathetically received and acted upon. Individual needs are well documented in care plan documents with clear instructions to staff on how to proceed, and these are regularly reviewed and Stairways DS0000019550.V264133.R01.S.doc Version 5.0 Page 6 updated by staff as necessary. There are robust recruitment and adult/child protection systems in place that should ensure the safety and well being of service users. Staffing levels are adequate in all areas. Recently recruited staff had received a thorough induction and other staff spoken with reported high levels of job satisfaction, good teamwork and communications as well as good support and supervision from the management. The organisation provides staff with excellent access to relevant training opportunities. The building has been well maintained and each unit is nicely decorated and appropriately furnished in domestic styles that provide a homely and comfortable environment. Living rooms and lounges have modern televisions and audio equipment and kitchens are modern and well equipped. Special equipment such as tailor-made wheelchairs and assisted baths are provided and serviced as necessary. All areas viewed were found to be warm, clean, reasonably tidy and fresh, apart from a slight odour detected in one bedroom in the children’s unit. Health and safety matters are being attended to. The assistant manager in charge during the inspection has long relevant experience and qualifications. She provides confident leadership and support to the team and is clearly competent to deputise in the absence of the registered manager. What has improved since the last inspection? The manager has requested Hertfordshire County Council’s Children Schools and Families Department to arrange reviews of each child’s placement plan and the matter has been raised at successive panel meetings. However, the requirement remains outstanding. Thermostatic mixer valves have been fitted to sinks in all at risk areas to limit the delivery of hot water to 43 degrees centigrade as required in the last inspection report. NVQ3 training for staff in the children’s unit is being given a higher profile and the home is working towards the 80 qualification standard. All staff spoken with confirmed that they had received regular one to one supervision. A new format for recording details of annual appraisals for all staff has been introduced. Plans for the partial redevelopment of the site to provide more modern facilities in line with current expectations have been devised and a consultation process commenced with service users, relatives and staff. This is particularly relevant to the children’s unit because the present building does not allow the full achievement of the aims of the service. Stairways DS0000019550.V264133.R01.S.doc Version 5.0 Page 7 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. Stairways DS0000019550.V264133.R01.S.doc Version 5.0 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Stairways DS0000019550.V264133.R01.S.doc Version 5.0 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 4 Adequate information is available to prospective and current service users to enable them to make an informed assessment of the aims of the home, the service promised and the arrangements for care. Thorough systems are in place to ensure that the needs of all service users including children placed are assessed prior to admission. Prospective service users have the opportunity to familiarise themselves with the home and assess the facilities and service provided by means of a lengthy trial period. EVIDENCE: The home has statement of purpose and service user’s guide documents for both adults and children that contain all the detail necessary to support an informed evaluation of the service they can expect to be delivered. These are available to service users and their relatives or representatives as appropriate. The current adult service users all moved in to the home many years ago, prior to the introduction of the National Minimum Standards. Even so, there are preadmission procedures ensure that any prospective resident is properly assessed to decide whether the home could meet their needs. Prospective service users and their relatives/friends would always be encouraged to visit the home to see the premises and facilities and meet other service users and staff. Preliminary overnight stays would be arranged if appropriate. A trial Stairways DS0000019550.V264133.R01.S.doc Version 5.0 Page 10 period of at least three months would follow admission, after which a placement review would take place with the service user, social worker, relatives and any other involved professionals to confirm the placement assuming it remained suitable. A prospective child is invited for several daytime visits and an overnight stay, prior to the first period of respite care. Examples of social workers’ assessments were present in children’s personal files seen. The home can admit a child in an emergency but for a maximum of 28 days only. Stairways DS0000019550.V264133.R01.S.doc Version 5.0 Page 11 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 the following standard(s): 6, 7, 9 Service users’ personal, emotional and social care needs and aspirations are detailed in individual care plans. However not all the children using the respite service have had placement plan reviews due to the inaction of the placing authority. Staff encourage and support service users to make decisions for themselves, act independently and take responsible risks. EVIDENCE: Care plans for adult service users and children contain detailed notes of the identified needs coupled with clear instructions to staff on how to proceed to meet them and achieve the goals set. Each service user’s keyworker compiles a monthly report reflecting any changes occurring. The care plan files seen were bulky and the inspector felt that they would be easier to use if streamlined somewhat. However staff in different units said they had no difficulty in accessing relevant information. Service users who expressed opinions were satisfied with their involvement in the care planning process. Stairways DS0000019550.V264133.R01.S.doc Version 5.0 Page 12 The assistant manager confirmed that placement plan reviews were still not taking place for Hertfordshire County Council placed children despite Stairways staff raising the matter at every panel meeting. This makes it very difficult for the home to comply fully with this requirement of the Children’s Homes Regulations. The promotion of individual choice and independence is one of the stated aims of the home and there was good evidence that this was being achieved. Service users asked were all positive about the amount of personal choice and freedom to act independently available to them, for example regarding cooking, holidays and social lives. In addition, observations of staff at work with residents showed that they understood the process of fostering independence by encouraging residents to do things for themselves. Some of the residents are already quite independent and receive only minimal assistance from staff. In the more dependent flats staff clearly encourage service users to make decisions and accept responsibilities. Responsible risk taking is also encouraged, with examples of appropriate risk assessments e.g. traffic, self-medication and so on in care plans. The two adolescent children spoken with in the respite unit said that they had a reasonable amount of freedom. Relationships between staff and service users in all areas appeared to be based on sound principles on mutual respect and trust. Stairways DS0000019550.V264133.R01.S.doc Version 5.0 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 the following standard(s): 12, 13, 14, 15, 16, 17 Staff support service users to enjoy full and meaningful lives as members of the local community. Service users clearly benefit from the opportunities for personal development and stimulation available. Social and recreational activities for service users and children are adequate and appropriate for their general welfare and development. Family contacts and other personal relationships are encouraged and facilitated. Routines in the home promote independence and balance individual rights and responsibilities. Service users have a healthy and balanced diet and mealtimes are pleasant social occasions. Children placed continue to benefit from the educational arrangements made for them. EVIDENCE: As indicated in individual progress records, service users have good access to local community resources. Staff are deployed as appropriate to facilitate Stairways DS0000019550.V264133.R01.S.doc Version 5.0 Page 14 planned activities for children. Service users and children spoken with said they enjoyed the various occupational and social activities they took part in and felt they had excellent opportunities for a fulfilling lifestyle. Children continue to attend their own schools whilst staying at Stairways. Placement plans cover their educational arrangements and staff maintain links with the various schools. As detailed in care plans, service users continue to enjoy a wide range of social and recreational activities according to individual choice, supported by staff as necessary. Leisure interests cover any identified religious and cultural needs as well as individual preferences and with respect to children and the pattern followed in the child’s own home. Several service users were planning to attend various activities such as football practice, on the evening of the inspection. Each unit has modern televisions, video/DVD players and audio equipment. Some service users have paid or voluntary jobs and others attend colleges, day centres and clubs. The home has several vehicles available for transporting service users on outings. The more able residents are responsible for some household chores on a rota basis including participating in menu planning, shopping and some cleaning tasks. Service users and children in all units have a well balanced diet, and all those asked said they were happy with the food provided. Staff were observed assisting the more dependent residents in one flat with feeding, in a gentle and sensitive manner. Risk assessments for each resident are regularly updated to minimise potential hazards. However staff recognise the importance of promoting residents’ independence in accordance with the aims of the home. Stairways DS0000019550.V264133.R01.S.doc Version 5.0 Page 15 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 the following standard(s): 18, 19, 20 Service users and children receive appropriate assistance from staff with their personal and healthcare by reference to the actions detailed in individual care plans. Individuals’ physical and emotional condition and progress are monitored to identify any potential problems and issues are dealt with promptly, with external professional support obtained as necessary. Sound procedures are in place for the safe handling and administration of medication that ensure the protection of service users. However the use of non-prescribed medicines should be formally authorised by the service user’s GP. EVIDENCE: The dependency levels of the service users vary considerably. Some live quite independently with minimal staff assistance whereas others have physical and mental disabilities that necessitate continuous one to one attention with the tasks of daily living or to deal with their behavioural difficulties. Staff know that any restrictions on personal freedom must be fully justified on therapeutic grounds and agreed on a multi-disciplinary basis with other care/health professionals and relatives, and these are documented in individual care plans. Stairways DS0000019550.V264133.R01.S.doc Version 5.0 Page 16 Service users generally choose their own clothes and are able to express their individuality. Technical aids and equipment needed to maximise the independence and/or care of service users are available as required. Adult service users are registered with a General Practitioner. Children retain their own GPs, as they only stay at the home for short periods. Residents have access to dentists, physiotherapists, occupational therapists, podiatrist, community nurses and other specialists in the ordinary way. Some of these professionals also contribute to individual care plans and attend whole life reviews. Sound medication systems are operated to protect the interests of service users. Medication in one flat was checked at this inspection and was being stored securely, with receipt, administration and disposal accurately recorded. However, several non-prescribed medicines were being held. The use of such items should be formally authorised by the resident’s GP, in accordance with the homely remedies policy (see recommendations). Stairways DS0000019550.V264133.R01.S.doc Version 5.0 Page 17 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 the following standard(s): 22, 23 An adequate complaints procedure is in place and service users fell that staff would respond sympathetically to any complaint made and act promptly to resolve it. Service users are protected from abuse, through the home’s written policies and procedures, including a staff whistle blowing policy as well as training provided for staff in adult and child protection. EVIDENCE: The complaints procedure is in the service user’s guides for both adults and children’s services. Service users and children consulted said they were aware of how to go about making a complaint and expressed confidence in the likely positive response of the manager and staff to any complaint made. Separate complaints records are maintained for adult and children services. No complaints had been received by the home since the last inspection. The home has a copy of the Hertfordshire procedures on child and adult protection. Comments received from the Local Area Child Protection Committee have been included in the home child protection procedures. Staff confirmed that they were familiar with the relevant procedures. Most care staff members working with adults have received training on the Protection of Vulnerable Adults. Basic grade staff working with children have received Child Protection Level 1 training and members of the management team received Child Protection Level 2 in January 2005, facilitated by the NSPCC. Stairways DS0000019550.V264133.R01.S.doc Version 5.0 Page 18 Observations of staff at work in the various units indicated that they were skilled and able to respond appropriately to acceptable and unacceptable behaviour. Due to the behavioural and emotional difficulties of some of the adults and children accommodated, occasionally staff intervene physically to restrain individuals. Appropriate records are kept of any incidents. A similar and separate record of any sanction applied to any child is also kept. Records examined and information gathered from staff and children suggested that physical interventions used were justifiable and sanctions imposed were fair and reasonable. Stairways DS0000019550.V264133.R01.S.doc Version 5.0 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 the following standard(s): 24, 30 The premises provide a safe, comfortable and homely environment suitable for the needs of the adult service users. However the layout and design of the building are not ideal and make it difficult to achieve fully the aims of the children’s unit. This will be addressed in the redevelopment of the site planned by Harpenden Mencap Society. The premises are clean, hygienic and virtually free from unpleasant odours. EVIDENCE: Each of the four adults’ flats is well maintained and decorated and furnished in domestic style to provide a very homely, comfortable and safe environment. All bedrooms seen were painted different colours chosen by the residents and were thoroughly personalised to reflect the tastes and interests of the occupants, with gadgets, pictures, hobby materials etc. The home has a hard wired fire detection system and smoke detectors throughout. The children’s respite unit has been maintained to the same standard and all rooms have been decorated, furnished and equipped to maximise their suitability for the use of children. However, the design of the rather elderly Stairways DS0000019550.V264133.R01.S.doc Version 5.0 Page 20 building limits the adaptations and improvements that could realistically be carried out to create a more child oriented physical environment, especially for wheelchair users or other physically disabled children. Space is relatively limited and the bathing facilities are unsophisticated. Nevertheless, staff have made great efforts to provide a safe and congenial environment and the two children spoken with said they liked the unit very much. The inspector visited every unit and found them all to be reasonably tidy as well as clean and free from unpleasant smells, apart from a slight odour in one unoccupied bedroom in the children’s unit. All the kitchens were clean, with food stored appropriately in fridges and temperatures recorded daily. The home has infection control policies and procedures in place and staff encourage residents to follow good hygiene practice. Arrangements for the storage and disposal of clinical waste were satisfactory. Stairways DS0000019550.V264133.R01.S.doc Version 5.0 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 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 36 Day and night staffing levels are satisfactory, with service users supported by skilled and knowledgeable staff capable of meeting individual needs. Staff receive regular relevant training support and supervision to enable them to act consistently to deliver a high quality service to residents and remain focused on achieving the aims of the home. EVIDENCE: There are separate staff teams for each unit. Staffing numbers and skill levels are considered adequate in each area, with staff having the necessary skills and training to meet the varying needs of the service users. For example in the more physically disabled adults’ flat the staff are skilled at attending to the primary care and medical needs of the residents and in other areas staff are adept at dealing with difficult behaviour and providing appropriate emotional support and guidance. Staff spoken with indicated that they had excellent opportunities for relevant training and this gave them greater confidence to do their jobs. It was evident during the inspection that staff understood the different requirements and approaches appropriate for individuals and were capable of balancing care and control with encouragement, friendship and risk taking. The level of insight displayed was commendable and this was reinforced by the positive comments made by service users. Stairways DS0000019550.V264133.R01.S.doc Version 5.0 Page 22 The home has not yet achieved the 50 NVQ2 staff qualification standard for adult services nor the 80 NVQ3 standard for children’s services, however the assistant manager stated that in both areas members of staff were on the relevant courses. Therefore the home is working towards meeting the standards. One recently recruited member of staff said that following her formal induction she had commenced Learning Disability Award Frameworkaccredited training. Staff spoken to confirmed that they were well supported and received regular formal supervision. The assistant manager described the current supervision structure that involves the delegation of supervisory responsibilities through the senior team thus ensuring the workload is spread. For example the assistant manager supervises the night staff. All staff receive an annual appraisal, now being recorded in a new format. Stairways DS0000019550.V264133.R01.S.doc Version 5.0 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 38, 42 Service users and staff feel that the home is well run and that the management team is effective. Service users’ health, safety and welfare are protected by policies and procedures that promote safe working practices and produce a safe living environment. EVIDENCE: Staff spoken with said they were very happy working at Stairways, were committed to the ethos of the home and felt that the leadership provided by the manager and senior team was effective. As indicated earlier in this report, observations made during the inspection of staff at work and documentation examined supported the conclusion that staff were working consistently in harmony with the home’s statement of purpose. The assistant manager was clearly able to offer constructive support and guidance to other staff, especially the newer and less experienced members of the team. Stairways DS0000019550.V264133.R01.S.doc Version 5.0 Page 24 Staff receive ongoing training in mandatory topics such as moving and handling, fire safety, food hygiene and so on to ensure safe working practices are followed. Equipment checked at this inspection such as hoists and fire extinguishers had been serviced within the last few months. Risk assessments were in place in respect of each service user and staff were familiar with the actions planned as control measures for example regarding activities outside the home or self-medication. Stairways DS0000019550.V264133.R01.S.doc Version 5.0 Page 25 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 3 3 X 3 X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 X 3 x Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X X X X X 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X 3 3 X X 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Stairways Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score X 3 X X X 3 x DS0000019550.V264133.R01.S.doc Version 5.0 Page 26 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 CH3 Regulation 12 Requirement Timescale for action 01/04/06 2. CH23 31 A formal system should be introduced, in order to ensure that each child has a placement plan review, involving the child, parents and professionals as appropriate. (Previous requirement). The physical design and layout of 01/04/06 the building are not suitable for the purpose of effectively achieving the aims and objectives of the childrens respite unit. (This would be addressed in the Organisations proposal to completely upgrade the accommodation for the adults and childrens services. The Director of Services to submit plans to the Commission for consideration. Stairways DS0000019550.V264133.R01.S.doc Version 5.0 Page 27 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. 2. Refer to Standard YA6 YA20 Good Practice Recommendations Care plan documentation should be streamlined to provide more accessible and user friendly working tools. The authorisation of the service user’s GP should be formally obtained in respect of any items of non-prescribed medication held in the home for possible administration. Stairways DS0000019550.V264133.R01.S.doc Version 5.0 Page 28 Commission for Social Care Inspection Hertfordshire Area Office Mercury House 1 Broadwater Road Welwyn Garden City Hertfordshire AL7 3BQ 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. 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