Inspection on 27/04/07 for Symonds House

This inspection was carried out on 27th April 2007.

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 no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Symonds House 10/02/06

Symonds House 21/07/05

Symonds House 24/03/05

Symonds House 22/07/04

Similar services:

Claremont House

Sun Court Nursing Home

Bramley Avenue (73)

15 Bramble Close

Dolphin Court

Fen Road

Wakes Hall

165 Putnoe Lane

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

CARE HOME ADULTS 18-65 Symonds House 2 Lavender Fields Lucas Lane Hitchin Hertfordshire SG5 2JB Lead Inspector Claire Farrier Unannounced Inspection 27th April 2007 10:00 Symonds House DS0000058598.V339032.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 Symonds House DS0000058598.V339032.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. Symonds House DS0000058598.V339032.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Symonds House Address 2 Lavender Fields Lucas Lane Hitchin Hertfordshire SG5 2JB 01462 452460 01462 440186 jennifer.alder@lc-uk.org www.leonard-cheshire.org.uk Leonard Cheshire 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) Mrs Jennifer Anne Alder Care Home 20 Category(ies) of Physical disability (20), Physical disability over registration, with number 65 years of age (20), Terminally ill (20) of places Symonds House DS0000058598.V339032.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10th February 2006 Brief Description of the Service: Symonds House is a purpose built establishment providing specialist support and personal care to twenty people with who have physical disabilities. The building is situated in the heart of the residential area of Hitchin, close to the town centre. It is a two storey property with the main living and residential areas all on the lower floor, and staffing facilities and a training suite available on the first floor. The building is surrounded by landscaped gardens with all areas accessible for wheelchair users. There is a large car park to the front of the building providing ample parking for staff and visitors and the home’s vehicles. The Statement of Purpose and Service Users Guide provide information about the home for referring social workers and prospective residents. The current charges range from £923.78 to £1307 per week. Symonds House DS0000058598.V339032.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out over one day. The focus of the inspection was to assess all the key standards, and some additional standards were also assessed. 18 residents completed Have Your Say surveys before the visit to the home, and the responses and some quotes from these have been used in this report. These give a representation of what the people who live in Symonds House think about the home. The majority of time during the visit to the home was spent talking to the residents, and one person showed the inspector around the building. Several members of staff also gave their views about the home, and discussions were held with the home’s manager. Some time was also spent looking at records, care plans and staff files. What the service does well: The home has a welcoming and sociable atmosphere. The ethos of Symonds House is that each person’s views are valued, and they are actively involved in the running of the home. The care plans are written with an emphasis on assisting and enabling the residents to be as independent as possible. The responses to Have Your Say surveys from the people who live in the home, the information in care plans, observation of the staff and residents, and discussions with staff and residents, all confirmed that everyone is encouraged to make their views and wishes known, and to make decisions about their lives in the home. The inspector asked a group of residents how many stars they would give the home. Most people gave the home a maximum three stars, one gave ten, and one gave twenty, as an expression of how highly they rate the quality of their life in the home. One person commented in the survey, “I am very happy to be at Symonds House, and hope they (the staff) are happy with me.” There is a stable staff team in the home, and the training programme ensures that they have the necessary skills to meet the residents’ needs. Most of the care staff have NVQ qualifications. The staff spoken to were enthusiastic about their work, and said that a good quality of training is provided for them. The staff were observed to have a good relationship with the people who live in the home and, with one exception, to treat them with a friendly respect. Health care is particularly notable, and evidence was seen that the home is proactive in promoting good health. Symonds House DS0000058598.V339032.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Symonds House DS0000058598.V339032.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 Symonds House DS0000058598.V339032.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): 2 and 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has sufficient information on residents’ needs and access to appropriate services to enable their needs to be met. EVIDENCE: Everyone who completed a Have Your Say survey for this inspection said that they were involved in choosing their home, and they had enough information to help them to decide. One resident has been admitted to the home since the last inspection. The referring social worker provided a detailed assessment, and the home’s assessment was completed before the person moved into the home. The assessment format is a checklist, with further details of any needs that are identified. The assessments that were seen provide sufficient information on each person’s personal care and health care needs, and form the basis of their care plan. The staff said that they have sufficient information and training to enable them to meet the residents’ needs. One resident is several years younger than the other people who live in the home. Their room is decorated in their own style, and they keep contact with friends of their own age. Symonds House DS0000058598.V339032.R01.S.doc Version 5.2 Page 9 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, 8 and 9 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The people who live in the home are actively involved in their own care planning and are consulted on every aspect of community life in the home. Risk taking is acknowledged as a consequence of daily living and full consultation takes place with individuals as part of the on-going review systems. EVIDENCE: Four care plans were inspected. They all provide good details of the support that each person needs, and they are written clearly and from the person’s point of view. The aim of the care that is provided for each person is to enable them to be as independent as possible, and the care plans are written to support this aim. For example, one person needs help with all aspects of his life. The support plan for the help that he needs with personal care has the aim, “For X to maintain his personal hygiene and comfort while preserving his dignity.” The support plan for mobility has the aim, “To promote independence and maintain safety.” The staff who were spoken to said that the care plans provide them with good information on each person’s needs, so that they are Symonds House DS0000058598.V339032.R01.S.doc Version 5.2 Page 10 able to provide a good quality of care in the way that each person wishes. The care plans include regular health and safety risk assessments, for example for moving and handling, and specific risk assessments, for example for the use of bed rails. The ethos of the home is to encourage each person to live a fulfilling life, and to manage any risks that may be associated with that aim. For example, one person goes out to the town independently, and the physiotherapist was involved in making sure that the chair he uses is suitable and as safe as possible for the purpose. A group of residents discussed with the inspector how they are involved in decision making about their lives in the home. They said that they are able to talk to the manager at any time. And during the day several people were observed talking to the manager and asking her questions. There is a monthly residents’ meeting for each unit, and the minutes are displayed on the notice boards. They show that the issues discussed include choices of meals and activities and outings. Some of the people who live in the home would like some changes made, in the decoration of the activities room and how it is used, and to provide a more spacious dining area. They have been involved in deciding how to use the activities room, and the colour they want for decoration, but changes to the dining area have net yet been agreed by Leonard Cheshire. One person is involved in the recruitment of staff, and takes a full part in the short listing and interviews of candidates. Almost everyone who completed a Have Your Say survey for this inspection said that they make decisions about their lives in the home and the staff listen and act on what they say. Two who disagreed with this said that they have problems with communication. Many of the people who live in the home have difficulties with communication, and several have no verbal communication. The care plans that were seen contain good details of each person’s particular needs for communicating what they want, and the staff were observed to follow the guidelines and to ask each resident what they wanted before assisting them. The staff are aware of the need to ensure that everyone is able to make their views known, and the evidence of this was seen in the care plans and by observation. The manager and staff are aware of the continuing need to ensure that everyone is enabled to make their views known as fully as possible. The home’s own survey showed the need to continue looking for ways to enhance communication with people who have profound problems expressing their needs. Only one person completed their survey without assistance, and most were assisted by a family member. There is a good team of volunteers who provide support to the home, both with activities as for some people as individual befrienders. Symonds House DS0000058598.V339032.R01.S.doc Version 5.2 Page 11 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, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people who live in the home are encouraged to live full and active lifestyles. EVIDENCE: The inspector joined a group of residents in the activity room during the morning. They were discussing items of news from the newspaper, lead by the activities co-ordinator. During a break for tea, they told the inspector about the activities they enjoy, and how they are involved with making decisions about what happens in the home. (See also Individual Needs and Choices.) There is one full time activities co-ordinator, who is in the home every day from Monday to Friday, and a part time co-ordinator who works for two mornings a week. There is an organised programme of group activities, with morning and afternoon sessions every weekday. These include craft activities, discussions, games and music. A gardening club has held one session, and planted some vegetables and salads in the raised beds outside the activities room. The home is supported by a large group of volunteers, and several of Symonds House DS0000058598.V339032.R01.S.doc Version 5.2 Page 12 these support individual people as befrienders, and assist them to carry out activities that they are unable to do independently. One person said that she enjoys one to one cooking sessions, and another goes out and does craft work with the help of a befriender. There is a computer room adjacent to the activities room, with appropriate equipment and software to enable most people to use the computers if they wish to. One person has their own personal computer, with Internet access. One of the volunteers gives instruction and assistance to those who need it. The activities room is available for everyone to use at any time, including evenings and weekends. However several people who completed Have Your Say surveys for this inspection commented that there are not enough activities at the weekend, and they can only do the things they want to do when there are staff available. Some of the people who joined the discussion with the inspector also said that they would like to do more at the weekends. As the discussion progressed, they agreed that what they most enjoy is getting together socially, and they then discussed ways that they may be able to arrange this for themselves. Later in the day, one person, who had said that she could not join in because she needs the assistance of staff to move her wheelchair, told the inspector that she had thought about this, and she could ask the other people to come to her. The residents are encouraged to do all the activities that they want to do, whether in groups or individually. The comments that not enough is organised at the weekends could be seen as a reflection of the high quality and variety of activities that are organised during the week. The home’s own survey showed the need to encourage recruitment of volunteers to enhance social time at weekends. No-one attends college or goes to work, but each person is encouraged and enabled to take part in activities that they want to do, and this would include college or other educational activities if they were appropriate. Two people attend separate day centres in the community that meet their specific needs and interests. One person is able to go out independently and to take visit the shops and other community facilities in the nearby town centre. Other residents are encouraged and enabled to take part in community activities. Some go shopping with the assistance of their befriender, and regular outings are arranged to places that people want to visit. On the day of the inspection, several people were going to the theatre in Stevenage in the evening. Friends and families are able to visit at any time, and during the inspection a member of staff who was not working that day visited with her daughter. The inspector had lunch with some of the residents. There is always a choice of meals that includes a vegetarian option, and if anyone wants something different, they can ask for soup or an omelette. Everyone said that the food is good, and mealtimes are a sociable occasion. One person said that she would like to have chocolate mousse for dessert instead of fruit. The member of staff told her that she could not have mousse because she was on a diet. This person’s care plan stated that she would like to control her weight, but there was no reason why she should not have her choice of dessert. In all other aspects the residents are given choices, and are encouraged to make their own Symonds House DS0000058598.V339032.R01.S.doc Version 5.2 Page 13 decisions about their lives. This was an unfortunate example that does not represent the good practice that was otherwise observed during the time that the inspector was in the home. But it indicates that the staff should ensure that each person’s right to take decisions for themselves is respected at all times. Symonds House DS0000058598.V339032.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, 19 and 20 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home has an experienced and enthusiastic team of staff, who have the training and skills to provide a good quality of care for the people who live in the home. EVIDENCE: The care plans that were inspected provide good details of the residents’ personal care and health care needs, and a good relationship was observed between the staff and the residents. Everyone who completed a Have Your Say survey for the inspection said that the staff treat them well, and the people who spoke to the inspector said that the staff are very good. The home has a good relationship and professional support from medical professionals. Most of the people who live in the home have complex needs, and all are wheelchair users. There is a well equipped physiotherapy room in the home, and full time physiotherapist who works in both Symonds House and the other Leonard Cheshire home for younger adults next door. Symonds House DS0000058598.V339032.R01.S.doc Version 5.2 Page 15 The assessments and reviews that are completed for each person include moving and handling, skin care and nutrition. One person has a PEG feed, as they are unable to swallow food and drink. The care plan contains good details and procedures for the care needed. The nursing staff continue their professional training so that they are aware of new developments in nursing care. The manager and senior staff are passionate about the promotion of good nutrition and skin care in order to prevent pressure sores. There are good procedures for the administration and recording of medication. One person has their medication mixed with yoghurt. This is how the person chooses to have it, so that it is easier to swallow, and they know that the yoghurt they are given contains medication. The temperature of the room where the medication is stored is not monitored. There was no indication that the temperature was too high on the day of the inspection, but there is no procedure to ensure that the temperature does not rise above 25°C. A high temperature may affect the quality of some medication, which could be a risk to the health of the people who take it. Symonds House DS0000058598.V339032.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 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people who live in the homes are encouraged and enabled to make their views and concerns known, and appropriate procedures are in place to ensure that they are protected from abuse and neglect. EVIDENCE: Almost everyone who completed a Have Your Say survey for the inspection said that they know who to speak to if they are unhappy, and they know how to make a complaint. The people who spoke to the inspector on the day said that they could always talk to the manager. No complaints have been recorded in the home. A formal written complaint would be recorded, but concerns and grumbles are dealt with as they arise by talking to the people concerned, and these are not recorded as complaints. The home has appropriate procedures for safeguarding vulnerable people. The staff spoken to were aware of the safeguarding procedures, and of their responsibilities for whistle blowing. Symonds House DS0000058598.V339032.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a comfortable and well maintained environment for the people who live there, and the staff maintain a good standard of hygiene and cleanliness. EVIDENCE: Symonds House is a new, purpose built building. It provides a comfortable and spacious environment for the people who live there. Everyone has their own room, which they have furnished and decorated to reflect their own interests and tastes. All the bedrooms have ensuite shower rooms, and track hoists are fitted from the bedrooms to the shower rooms. One person, who moved to Symonds House from the old Leonard Cheshire home, said that the best thing about the new home is that everyone has their own toilet and they no longer have to queue for the toilet and bathroom. One person showed the inspector the environmental control that has been fitted in her bedroom, which enables her to control her environment from her bed, including opening and closing the curtains and operating her TV and music system. Symonds House DS0000058598.V339032.R01.S.doc Version 5.2 Page 18 The building was very clean throughout, and well maintained and decorated. The residents have identified some changes that are needed. They have been involved in choosing the paint and lighting to redecorate the activities room. The dining room on one wing does not provide enough space for ten people in wheelchairs to use it in comfort. This has been raised by some of the residents, but there are no plans to change it in the immediate future. There is a kitchen area in the dining room on each unit, where breakfasts and drinks and snacks can be prepared. The fridge temperatures are monitored to ensure that food is stored at a safe temperature. However on both units the temperatures were recorded as between 6°C and 10°C. The recommended range for food hygiene is between 2°C and 8°C. In one kitchen some toilet cleaner and fly killer was seen on an open shelf, accessible to the residents. (See Conduct and Management of the Home.) Symonds House DS0000058598.V339032.R01.S.doc Version 5.2 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 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34 and 35 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Irrespective of their job descriptions and professional status, all staff appeared to be wholly dedicated to understanding and meeting resident’s needs. EVIDENCE: The home has a team of experienced and well trained staff who are able to offer continuity of care for the residents. Many of these carers worked at the old Leonard Cheshire home, and moved to Symonds House when it opened. During this inspection the staff all appeared to be enthusiastic about their work and to take great pride in the service and in the home. They were seen to work well together as a team and to work meeting the residents needs in a competent manner. One person said, “The home is second to none, both for residents and for staff.” Everyone who completed a Have Your Say survey for the inspection said that the staff treat them well. The home has a good level of staffing, with seven or eight care assistants throughout the day, four care assistants in the evening, and two during the night. There is at least one qualified nurse in the home at all times. Symonds House DS0000058598.V339032.R01.S.doc Version 5.2 Page 20 The numbers of staff holding professional qualifications, NVQ s at levels two and three considerably exceeds the requirement for 50 . The staff spoken to confirmed that there is a lot of training available, and the courses are very good. Induction training for new staff includes one week of mandatory health and safety training, followed by at least two weeks shadowing more experienced staff and supernumerary to the rota. The staff spoken to said that if they are not confident, they can shadow for longer. One person was on her first day in the home not shadowing. She had no previous experience of care work, and the support that was provided from the management and the other staff was excellent. The home’s records showed that a yearly plan is made up from the individual training requirements of each member of staff, which core retraining planned on an annual basis. Training is also available for any specific needs, such as understanding multiple sclerosis and behaviour management. A specialist nurse from Leonard Cheshire HQ came to give some training and advice to the staff on behaviour management for one resident. The files of two members of staff who have recently started to work in the home were inspected. They showed evidence of a thorough recruitment procedure, including comprehensive application forms, references and notes of the interviews. One resident takes part in staff recruitment of staff, and sits on the interview panels. Symonds House DS0000058598.V339032.R01.S.doc Version 5.2 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 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed, and the management actively seeks the views of the residents and other involved people in order to ensure that a good quality of care is provided. EVIDENCE: A new manager was appointed in July 2006, following the retirement of the previous manager. She had worked for Leonard Cheshire, at Symonds House and the predecessor home, since 1995 as the senior nurse, with the responsibilities of deputy manager. She has appropriate qualifications and experience to manage a home providing nursing care for younger adults with disabilities. The management style is to value and support the staff, and to be available to the people who live in the home. Both the residents and staff said that the manager is always available to talk to, and this was observed during the day. The ethos of the home is that it is the home of the residents, and the Symonds House DS0000058598.V339032.R01.S.doc Version 5.2 Page 22 staff support them to live their lives as they wish to. Everyone who lives in the home are wheelchair users, and some have very high physical and nursing needs, including difficulties with communication. The responses to Have Your Say surveys from the people who live in the home, the information in care plans, observation of the staff and residents, and discussions with staff and residents, all confirmed that everyone is encouraged to make their views and wishes known. One observation contradicted this (see Lifestyle), but this did not detract from the overall view of the ethos of the home. The home has a sound quality assurance system in place that meets the needs of the service. The organisation carries out monthly monitoring visits to the home that include talking to the people who live there. There are regular residents’ meetings on each unit. Leonard Cheshire carry out an annual survey of the people who live in the home. The report of the survey completed in January 2007 showed very similar results to the CSCI Have Your Say survey for this inspection. In particular, 70 of the residents thought that the service they were receiving at Symonds House was excellent, but 5 were not able to discuss issues due to communication difficulties. The recommendations from the home’s survey also coincide with the findings from this inspection: to encourage recruitment of volunteers to enhance social time at weekends, and to continue looking for ways to enhance communication with people who have profound problems expressing their needs. The home maintains appropriate records for the health and safety of the residents and staff in the home, and staff generally follow the home’s policies and procedures. However during the inspection one health and safety concern was noted. Cleaning items, including toilet cleaner and fly killer, were seen on a low level open shelf in Bluebell kitchen. These items were easily accessible to the people who live in the home, and may cause a risk to the health and welfare of vulnerable residents. They were removed immediately. An immediate requirement was made to ensure that more care is taken in the future with the storage of items that may be hazardous to health. Symonds House DS0000058598.V339032.R01.S.doc Version 5.2 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. 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 X 2 3 3 3 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 3 30 3 STAFFING Standard No Score 31 X 32 4 33 3 34 3 35 4 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 3 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 2 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 4 2 X 3 4 3 X X 2 X Symonds House DS0000058598.V339032.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? NO 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 YA16 Regulation 12(3) Requirement The registered person must ensure that the care staff understand the need to treat residents with respect at all times. Measures must be put in place to ensure that all substances that may be hazardous to health are stored securely at all times, in order to ensure that there is no risk to the health and welfare of vulnerable residents. Timescale for action 31/05/07 2. YA42 13(4)(a) 27/04/07 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 YA20 Good Practice Recommendations Consideration should be given to monitoring the temperature of the room where medication is stored. All medication should be stored at the temperature recommended by the manufacturer, to ensure that its integrity is maintained, and there is no risk to the people who use it Symonds House DS0000058598.V339032.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Hertfordshire Area Team CPC1 Capital Park Fulbourn Cambridge CB21 5XE 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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