Inspection on 01/11/06 for Stibbs House

This inspection was carried out on 1st November 2006.

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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Stibbs House 28/01/08

Stibbs House 06/12/05

Stibbs House 03/06/05

Stibbs House 22/12/04

Stibbs House 24/05/04

Similar services:

2 Perhaver Park

The Vicarage

7 Hyde Road

St George`s

5 Seafield Road

Credence House

Radfords

Trevaylor Manor

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

CARE HOME ADULTS 18-65 Stibbs House 74 Stibbs Hill St George Bristol BS5 8NA Lead Inspector Andrew Pollard Key Unannounced Inspection 1st November 2006 09:30 Stibbs House DS0000020256.V317039.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Stibbs House DS0000020256.V317039.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Stibbs House DS0000020256.V317039.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Stibbs House Address 74 Stibbs Hill St George Bristol BS5 8NA 0117 9619137 0117 9476786 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) admin@aspectsandmilestones.org.uk Aspects and Milestones Trust Ms Anstey acting manager Care Home 10 Category(ies) of Learning disability (10), Physical disability (10) registration, with number of places Stibbs House DS0000020256.V317039.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 10 Adults with learning disabilities which may include those with physical disabilities Manager must be a RN on parts 5 or 14 of the NMC register Date of last inspection 6th December 2005 Brief Description of the Service: Stibbs House is a registered care home with nursing offering respite care for up to 10 people who have learning disabilities, in particular those who have profound multiple disabilities. The majority of service users are in need of nursing care. The care staff are experienced in this type of care and are led by a team of Registered Nurses. The house is situated in a suburban area and is easily accessible by car or bus. There is easy access to local shops and community facilities. The home is a modern purpose built including a recently completed extension to create extra rooms. There is a large secure garden and patio. There are 10 single rooms on two floors accessible by a lift. There are two lounges, a dining room and a multi sensory room. Stibbs House DS0000020256.V317039.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The following methods of evidence gathering have been used in the production of this report; observation, discussion with residents& staff, survey information from relatives a tour of the home and sampling policies, records and care plans. Seven relatives returned comment cards all of who were satisfied with the overall standard of care one saying that “The standards of nursing care are excellent”. Only three clients were present during the inspection one was able to verbally communicate. Stibbs House is a well run short stay home offering good standards of nursing and personal care. The judgements and report are based on all available information including a site visit. What the service does well: What has improved since the last inspection? Care plans are signed and dated by the accountable nurse and are being updated and reordered. Stibbs House DS0000020256.V317039.R01.S.doc Version 5.2 Page 6 Redecoration and refitting of the kitchen has been completed. A medicine disposal contract is in place. A gas safety inspection has been carried out. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Stibbs House DS0000020256.V317039.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Stibbs House DS0000020256.V317039.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective clients have the information they require. Assessments and admissions are properly managed for the benefit of the families. The staff have been successful in offering person centred care, maintaining peoples life skills and providing therapeutic support based upon assessed needs and aspirations. EVIDENCE: The statement of purpose and service user guide are as previously and include information about other day services provided by the Trust. The service user guide is also available on audiotape but not used to date. The expectation is that when a new manager is confirmed in post these documents will be fully revised and updated. Stibbs House DS0000020256.V317039.R01.S.doc Version 5.2 Page 9 All families who responded to the survey said ”They were kept informed about important matters affecting their relative and were welcomed into the home at any time”. Consideration is being given to offer day care services at the home in the time when clients are at their placements. Aspects and Milestones Care Trust issue a standard set of terms and conditions and have contracts with Bristol and South Glos local Authorities each having four beds and one emergency bed available. There are approximately 54 current clients currently registered with the service. The general level of dependency of recent referrals has remained high. All clients have a care management assessment by a social worker and health assessment. In addition the manger or one of the Registered Nurses carries out an assessment prior to the first trial visit. There is a new assessment document for community services in use, which provides comprehensive details of clients care needs. The assessments of recent admissions were detailed and gave a clear picture of the person. There are a number of clients who have specific cultural needs and case files showed evidence that these issues had been discussed and agreed with families and relevant entries made in the case file. The Roper model of care is the basis of the assessment and care documentation. A letter confirming the home’s ability to meet the assessed need is sent to the prospective clients with a copy of the assessment. Stibbs House DS0000020256.V317039.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There was good evidence of needs and risk assessment reviews being carried out and clearly written care plans. The home’s philosophy promotes client’s self-direction and empowerment within the limits of their disabilities. EVIDENCE: The ethos of the home is based on empowerment, maintenance of independence and choice for clients. Care plans are based on the activities of living and were well written holistic and detailed, however a number require updating which is being done by the Stibbs House DS0000020256.V317039.R01.S.doc Version 5.2 Page 11 named nurses and key workers. The manager intends to have family meeting days in January and February to carry out comprehensive reassessment and updating of case files. Thereafter reviews will be six monthly or as required. This process will now be repeated annually. Staff are invited to Social Services reviews and where possible attend. All clients have risk assessments to validate any restrictions on freedoms. The final care plan is discussed with the client and/or relative who are invited to sign it indicating their acceptance of it including the use of bed rails where appropriate. In practice it is the families who sign off the care plans as in general the clients have profound disabilities and are unable to do so. Three entries per day are made in each person’s continuing care notes and noted in the house report. A communication diary is maintained with families, which goes back and forth with the client. The home has good liaison with Social Workers, community nurses and day services or schools. Only a small number of clients have verbal communication skills. Decisions and choice are explored with the clients through discussion with families and the staff’s experience and knowledge of their non-verbal communication. All people have individualised risk assessments but it is accepted that reasonable risk taking is part of normal life. Risk is managed in consultation with the client/family. There is a very low level of accidents in the home. Stibbs House DS0000020256.V317039.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Clients continue to take part in a range of community and leisure activities. The recreational arrangements in the home are well organised and varied. The menus are varied and individually tailored. EVIDENCE: The manager and staff consider promotion of independence and maintenance of life skills to be of a priority whilst accepting that they only play a small part in the person’s life. The care regime is person-centred and individualised. Where possible people continue to attend their day care placements and social Stibbs House DS0000020256.V317039.R01.S.doc Version 5.2 Page 13 activities whilst having respite care. The home has good liaison and working arrangements with day centres. Every effort is made to maintain continuity of care between client’s homes and Stibbs House via the client diary, meetings with the family or home visits. As a respite care unit individuals are not seeking integration in the local community, however the service is well accepted within the local area. The staff and clients make use of local facilities and help them maintain existing links with community services. At weekends the staff try to arrange social and leisure activities tailored to the individuals including trips out in the minibus to places such as Longleat, garden centres, walks and shopping trips. Choice is central in the way the home is run but it is accepted that many clients are unable to express their wishes in any formal sense and understanding their likes and dislikes is through experience, building relationships and good communication with families. Client’s preferences are discussed as part of the initial assessment process. All of the relatives who responded to the survey said, “They were consulted about their child’s care”. A house Christmas coffee and mince pies morning is being arranged prior to the holiday period. The house is closed from Christmas Eve to 2nd January 07. Mealtimes are flexible. Meal choices are individualised and planned day to day. Many people eat a main meal at their day centres on weekdays. Special and culturally appropriate diets are catered for. Staff can manage all types of feeding regimes including peg feeds and nasal gastric tubes. Records of meals are maintained in the diary. Stibbs House DS0000020256.V317039.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18-21 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The staff provide appropriate personal and nursing care in a sensitive manner to maintain clients health and well-being. Gender preferences for personal care are respected where possible. Appropriate arrangements are in place for clients to access primary healthcare services if need be. In general the staff properly manage and administer medication and the medication policy is being complied with other than the return of medication home. Arrangements are in place to manage clients with terminal disease. EVIDENCE: The named nurse and key worker system has been reviewed and continues. Stibbs House DS0000020256.V317039.R01.S.doc Version 5.2 Page 15 Home visits and care plan evaluation meetings enhance links between staff and the families. Appropriate staffing arrangements can be put in place to meet individual clients needs. The manager considers the skill mix needs to be reviewed to ensure nurses have the relevant skills and experience to manage some of the more complex care needs. A review of the daily allocation of staff is also to be carried out. The home has in the past accepted clients with terminal illness and some of the staff have received appropriate training from the Hospice regarding symptom control. The staff have good communication skills and are aware that changes in behaviour for people without verbal communication can sometimes be indicative of a care need. In general people stay with their own GP during their respite care. However there are arrangements in place with local surgeries at Airballoon Rd and St George to provide care for people as temporary clients and for emergency cover. This service is rarely used. The staff have good working arrangements with local community learning disability and district nursing teams. None of the clients are able to self medicate. The relevant GP sends a letter detailing medication and any changes; in addition the family will provide information where recent changes have been made. Everyone has a medication profile. Some nurses have been trained in the use of Midazolam for epilepsy. The records of drugs received and sent home were in order. The medicine administration record sheets were up to date and in order running stock totals are maintained. The disposal record was in order and a proper contract and new policy put in place. There were packets of Midazolam and Morphine Sulphate in the drug cabinet although the clients were not staying at the home at the time. These drugs should be returned home with the clients. The CD book did not always have double signatures for each entry. Stibbs House DS0000020256.V317039.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The staff are aware of the Trust’s complaints and Protection Of Vulnerable Adults (POVA) policies and are trained in putting them into practice to protect residents from abuse. The record keeping related to client’s money is not of the required standard. The clients and their families are aware of the complaints procedure. The manager and staff have worked hard maintaining good relationships and open communication with carers and relatives. EVIDENCE: The complaint procedure is clearly set out in the service user guide and reference to CSCI is included. There is an audio version available if needed. There has been one complaint about a nurse’s attitude, which has been resolved, and the manager stated that the family were satisfied that the issue had been properly dealt with. Complaints in the past have been satisfactorily resolved using the internal complaint procedure. None of the relatives who responded to the survey have Stibbs House DS0000020256.V317039.R01.S.doc Version 5.2 Page 17 had cause for complaint. One person was concerned that some items of clothing had been mislaid. The Trust has appropriate policies for the protection of vulnerable adults, local Authority “No Secrets” guidance and “Whistle Blowing” policies. There have been no recent POVA matters. The manager and staff are aware of the Nursing Midwifery Council and General Social Care Council code of conduct and copies of such are available to staff. Any aspects of challenging behaviour are addressed as part of care planning. At present only one person is considered to have the potential to exhibit behaviour that challenges the service. The manager considers that the staff team require positive restraint training updates in the near future. The home does not have detailed and accurate financial records of clients deposits, withdraws, receipts and balances of money held in safekeeping. All entries should be double signed. The ledger sheets contained many omissions. Stibbs House DS0000020256.V317039.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 27, 28, 29, 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The requirement to decorate the ground floor corridor has not been met. The house provides a clean, comfortable and safe environment for the clients. Provision of bath linen is of poor quality. The bedrooms and communal rooms and facilities are suitable for their purpose and meet the resident’s needs. Residents have any specialist equipment they presently require to promote their independence. Emergency equipment could not be used. Stibbs House DS0000020256.V317039.R01.S.doc Version 5.2 Page 19 EVIDENCE: The home is purpose built and is fit for its purpose. The house has an enclosed but large garden and patio. All bedrooms, communal spaces and facilities are fully accessible and suitable for disabled people. The fittings and furnishings are of good quality and of a domestic nature. The home was cleaned to a high standard and in general good order. There were no malodours. The laundry arrangements are satisfactory, however consideration needs to be given to relocate the spare machine from the sluice. The home provides only a limited laundry service. One washing machine is currently out of order awaiting repair. On examination of the laundry store a number of towels were found to be fraying and in need of replacement. A copy of the infection control manual is available. Proper arrangements are in place to dispose of domestic and clinical waste. Rooms are basically equipped and adequately furnished as the home offers only respite care. Bedrooms have electrically adjustable beds and pressure relieving mattresses to meet varying levels of risk. A number of beds are fitted with bedrails and the manager is to undertake a review of their fitment to ensure they are safe and do not allow a persons head to become trapped between the rail and the bed head. Some clients bring their own special equipment as required each time they visit. The home has a range of special baths, beds and lifting and handling equipment. A well-equipped multi sensory room is on the first floor. All radiators are of low surface temperature design. Bath and shower hot water outlet temperatures are regulated and monitored. The home has an appropriate number of toilets and bathrooms including a wheel in shower and new hi-lo baths with Jacuzzi. Stibbs House DS0000020256.V317039.R01.S.doc Version 5.2 Page 20 The home has a suction machine for emergency use but it was disassembled and could not have been quickly used if needed. The kitchen has been refitted to a high standard in accord with the Environmental Health Officer’s requirements. As identified in the last report the main corridor is in need of repainting and installation of protection strips on the walls this is the second occasion on which a requirement had been made and the deadline for completion not complied with. A regulation manager will be writing to the Responsible Individual Mr Akers regarding this matter. Stibbs House DS0000020256.V317039.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32-35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. An appropriate and robust recruitment procedure is in place. The staff are experienced and trained to meet the individual and joint needs of the residents. The staff skill mix and staffing levels are conducive to maintaining and enhancing the resident’s quality of life. The manager demonstrated a commitment to focus on training. EVIDENCE: The staffing levels are in accord or exceed the staffing notice (Jan 05) but as there are no housekeeping staff care staff carry out this function, which accounts for the additional care assistant hours being in excess of the 18.5 hours required. Stibbs House DS0000020256.V317039.R01.S.doc Version 5.2 Page 22 The occupancy and dependency levels remain high. When the house is full and dependency indicates the need, four staff are on duty during the day and a minimum of two waking night staff. The manager is always supernumerary. The skill mix is satisfactory. The nursing and care staff are experienced with the client group. Where possible the manager uses additional staff at the weekend to facilitate social activities, as there are no day placements on these days. However thought is being given to enhance staffing in the mornings as this is frequently the busiest time of day and time deadlines have to be met for transport. There are two nursing staff vacancies at present (aprox 56hrs). The deputy manager post has been lost and an E grade nurse has been recruited. One relative who responded felt there was not always an adequate number of staff on duty. Other comments included, “The staff are always friendly and the standard of nursing care is excellent”. There is a large amount of routine admin work associated with a respite care service that was previously well managed on site until the admin support was withdrawn. There have been a number of difficulties resulting from this. The Trust have reinstated only 5 hours of admin time which both the manager and admin person consider inadequate. The recruitment policies and procedures are of a high standard. The manager will be involved in all staff interviews. The personnel department carries out the Nursing & Midwifery Council and CRB/POVA checks of RN’s and care staff. Copies of all records as required by Schedule 4.6 (b), (c) are kept in the home, although those of the most recently appointed staff had yet to be received. There are low levels of sickness but staff turnover has been high. There has been moderate to high use of bank and agency staff. Any bank or agency staff undergo a detailed orientation to the home as well as a Trust induction programme. The manager considers staff morale has suffered with the uncertain staffing but is improving again. The trust has an induction and orientation programme for new employees who work through the LDAF induction process prior to completing NVQ level 3. There are to be four NVQ assessors in the home. The home has met the target of 50 of care staff NVQ trained. The RN training and clinical up dating was not reviewed on this occasion. Stibbs House DS0000020256.V317039.R01.S.doc Version 5.2 Page 23 There are appropriate supervision arrangements in place following the reassignment of named nurses and key workers. The manager is focusing on identifying learning needs when the appraisal process begins later this year. Stibbs House DS0000020256.V317039.R01.S.doc Version 5.2 Page 24 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42, 43 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management of the home needs improvement. There are various methods and systems in place to obtain clients/relatives views. There are appropriate arrangements in place to service and repair plant and equipment. The home has good Health and Safety arrangements. Stibbs House DS0000020256.V317039.R01.S.doc Version 5.2 Page 25 EVIDENCE: Ms Anstey had been seconded from Fairburn to Stibbs until April 07 and subsequently asked to manage Stibbs House but was unaware that she should submitt an application for fitness assessment, she has undretaken to commence the process immediately. Stibbs House and Fairburn the two respite care homes are seeking to work in a more co-ordinated way and have common systems and documentation. The two managers offer each other peer review and support. Combined Registered nurse days with Fairburn are planned and a whole community services away day is taking place later this month. A comprehensive survey of service users/relatives views was carried out in December of last year. The results overall were positive. Much helpful and positive feedback was gained from the care plan reviews in which 28 families took part. The general opinion is that Stibbs house offers a flexilbe, reliable and high quality service. The review meetings and surveys will be repeated in the new year. A further survey is to take place in the new year and a repeat of the family consutation excersise is arranged during January and February 07. All of the seven relative comment cards gave positive responses and no negative comments were received other than one reference made to laundry being lost. All families have a feedback diary to assist communication between the home and family and allow for any concerns to be raised. This process will feed into the annual plan, along with the identified learning needs from the staff appraisal process. A draft copy of the business plan has been supplied to the Commission. A full Health and Safety policy is in place for which the manager has delegated responsibility to one of the Nurses. Monthly Health and Safety audits take place. A fire risk assessment has been carried out. The fire log book is kept up to date. All doors have been fitted with automatic fire closers. Stibbs House DS0000020256.V317039.R01.S.doc Version 5.2 Page 26 The Trust has a good system to deliver training and updates in Health and Safety, First Aid, load handling, fire safety and food safety. Staff have received update training annually which was supprted by the training records. Appropriate maintenance systems are in place for plant and equipment other than the boiler. The boilers were out of action on the day of the visit but were temporarily fixed by lunch time. There appeared to be no formal contract in place to deal with this issue and a final solution was still to be found. The gas safety inspection certificate was in order. The EHO carried out an inspection in the summer which required the kitchen to be upgraded. Fitment of the new kitchen was completed earlier this year. The electrical installation safety certificate was been reissued. PAT checks are carried out annually. The lift and hoists have been load tested and serviced. The Insurance liability certificate was on display. Regular visits are made by the Trust manager and the quality of services reviewed. Regulation 26 reports are submitted regularly. Stibbs House DS0000020256.V317039.R01.S.doc Version 5.2 Page 27 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 2 3 3 3 4 x 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 2 25 3 26 X 27 2 28 3 29 2 30 3 STAFFING Standard No Score 31 X 32 3 33 2 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 3 2 X 3 X X 2 2 Stibbs House DS0000020256.V317039.R01.S.doc Version 5.2 Page 28 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action 1. YA24 23.2 (p) Have contract arrangements in 30/11/06 place to service and maintain the boiler. 2. YA29 23.2 (c) Ensure the suction machine is in 30/11/06 working order fit for immediate use. 3. YA27 16. 2 (c) Replace worn towels. 30/11/06 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. 3. 4. 5. Refer to Standard YA1 YA33 YA23 YA35 YA20 Good Practice Recommendations Carry out a full revision and updating of the Statement of Purpose and Service User Guide when the new manager takes post. Consider an increase of admin time at Stibbs house. Keep detailed and accurate financial records of clients deposits, withdraws, receipts and balances of money held in safekeeping. Arrange for the staff team to attend positive restraint training updates in the near future. Ensure all drugs are returned home with the clients. The CD book should have double signatures for each entry. Stibbs House DS0000020256.V317039.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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