Inspection on 14/08/07 for The Chimes

This inspection was carried out on 14th August 2007.

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 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Chimes 29/07/08

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

Extracts from inspection reports are licensed from CQC, this page was updated on 28/09/2008.

CARE HOME ADULTS 18-65 The Chimes 25 Grosvenor Road Paignton Devon TQ4 5AZ Lead Inspector Anita Sutcliffe Key Unannounced Inspection 14th August 2007 10:00 The Chimes DS0000070223.V369539.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 The Chimes DS0000070223.V369539.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. The Chimes DS0000070223.V369539.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Chimes Address 25 Grosvenor Road Paignton Devon TQ4 5AZ 01803 559205 01803 559205 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) Diamond Care (2000) Limited Mrs Karen Barnes Care Home 10 Category(ies) of Learning disability (10), Learning disability over registration, with number 65 years of age (10) of places The Chimes DS0000070223.V369539.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th February 2007 Brief Description of the Service: The Chimes is registered to provide accommodation and care for a maximum of ten people who have learning disabilities. Both younger adults and people over sixty-five years of age can be accommodated. The Chimes is situated in a residential area of Paignton and is within walking distance of the town centre, bus and train stations. The sea front is less than one mile away. Accommodation is provided over two floors with stairs between. On the ground floor are a kitchen, dining room and lounge. On the first floor is a laundry room. There is parking space at the front of the building and a small garden with patio at the rear. This has different levels making wheelchair access difficult. Information about the service is made available in a Statement of Purpose and in Service Users Guides. Copies of these documents are available on request or can be viewed at the Home. Inspection reports are made accessible to service users and visitors at the home or can be accessed on the CSCI Website. The weekly fees currently range from £367.20 to £985.37. The Service Users’ Guide states that this includes all care support costs, accommodation, food and drink, heating, lighting, laundry, staff services and annual holidays. The home has recently been re registered under the company name of Diamond Care (2000) Limited. The registration under the name of Mrs. Smith has therefore now ceased. The Chimes DS0000070223.V369539.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is what we did • • • • • • • • We inspected the home to find out what it is like to live there. We asked families staff and visitors for their opinions about the home We visited the home without letting people know we were coming We met all the people who live in the home We looked around the building We talked with staff and the Manager We watched staff doing their work We looked at records about the home, staff and people who live there. What the service does well: What they do well The Chimes is clean, comfortable and homely. It is close to the town centre. Bus and train stations are nearby. People who live at the Chimes are helped to get the things they need and do what they want. Staff know how to help people to do this. The Manager and staff are good at helping people to make decisions about how they want to spend their time. People are protected from abuse. They know they can talk with the staff and Manager if they have any worries. The Manager makes sure that staff give a good, safe service to people who live at the Chimes. The Manager knows how to manage the Chimes properly and thinks of ways to improve it. The Chimes is a safe place for people to live. The Chimes DS0000070223.V369539.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. The Chimes DS0000070223.V369539.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 The Chimes DS0000070223.V369539.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): Standards 1 & 2 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People have enough information to make a choice about living at the Chimes. EVIDENCE: Surveys completed by residents confirmed that they had been asked if they wanted to move into the home and that they had enough information to decide if it was the right place for them. One added: “Yes, I came to visit before I moved in”. The manager said that the last admission to the home was in 2006, before the previous key inspection. The person had lived at the home previously, so already knew a lot about it. Another resident, admitted within the last 12 months, talked about when she came to have a look around the home. We discussed this with both her and a support worker. The manager said that referral to the home is usually through social services. The potential resident and any family then visit. “They have a chat and meet people”. A copy of the Service Users’ guide is given (which contains pictures). The Chimes DS0000070223.V369539.R01.S.doc Version 5.2 Page 9 The manager added that she intends to do the same with other information about the home so that the information is as clear as possible. The person is then offered to join other residents for a meal. Then, if they’re still interested, they have an overnight visit. There is then a three months trial visit. This is documented in the contract. When asked how much involvement the person has in their own assessment the manager said: “The potential service user is always present, plus a care manager”. At the last key inspection the manager was required to ensure copies of the Service User’s Guide and Statement of Purpose are forwarded to the Commission whenever they are amended or updated as the information contained in these documents is used for inspection purposes. This has been done. Now that the registration of the home has changed, residents’ contracts will need to be renewed. The manager said this is already in progress. The Chimes DS0000070223.V369539.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 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are included in making decisions about their own lives. They take part in planning the care and support they receive. EVIDENCE: Discussion with two support workers and the manager, with input from residents, showed the good level of staff awareness of how to support residents in living the lifestyle they wish. Residents talked of what they are able to do and how support is arranged. A community nurse said: “They encourage people to take responsibility for their actions”. Two residents surveyed said they always make decisions about what they do each day and three said they sometimes do. Comments included: “We always fill in an activity sheet on a Monday and give ideas of things to do” and “I always make my own decisions”. We observed residents deciding how to spend their afternoon and were shown records of choices made, such as who The Chimes DS0000070223.V369539.R01.S.doc Version 5.2 Page 11 wants to help with cooking. We also observed residents engrossed in tidying their rooms and sorting their belongings. A support worker said that care plans are available to residents who are ‘quite aware’ of their records and the planned care. A resident was present and agreed with this. The plans are locked in a cabinet in the dining room. They were generally orderly and covered assessment and planned support, care and risk assessment. Risk is discussed with the resident and other agencies which might need involvement, such as care managers. Evidence supports that residents are encouraged to make their wishes known, are supported to lead the lives they wish and that risk is well considered and managed. Daily records of events, previously being kept in a hardback book, are now only found within individual resident files. This ensures that information is kept confidentially. The Chimes DS0000070223.V369539.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, 16 & 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are able to make many choices about how they want to live. They have support to improve their skills, interests, hobbies and education. They also have fun. EVIDENCE: We observed a group of residents being offered options of what they could do. These included maths, English or Spanish (ready for their holiday) or making jewellery. The group were relaxed and these options were clearly not a surprise to them. The manager talked of one resident’s growing confidence. The resident said how much she likes to cook and she had several entries on a cooking rota. The manager said that her behaviour, previously a problem to her and others, is now much less evident. This has given her increased confidence; where The Chimes DS0000070223.V369539.R01.S.doc Version 5.2 Page 13 previously she would not stop at the day centre alone now she will. A community nurse said: “They encourage people to take responsibility for their actions”. Activities enjoyed by residents and supported at the home include: Making things for the church to which several residents belong. Arts and crafts, including jewellery making, of which there were very many examples seen. Working at a farm. The resident talked of the cows, piglets, and hens and how the farm overlooks the river Dart. All the residents are going to Tenerife in September. Last year they went to North Devon – photographs were seen of this. Residents are learning some Spanish phrases such as ‘hello’ and ‘thank you’. Local events – there was a fair “last week”. Access to day centre and education – a resident attended during the inspection visit. Shopping for food on Thursdays. Horse riding, swimming, a gym, cafe’s and going to the pub. Working in a charity shop. There were photographs of previous special events such as fancy dress for Halloween and last years holiday. - A resident said: “I like this home and mostly feel happy especially when I go out shopping on a Tuesday or Wednesday and always on a Saturday with my family”. A resident’s family said: “My daughter is treated as part of the Chimes family. She gets social, educational and religious support”. The home works hard in supporting residents’ rights and citizenship. Both family relationships and new relationships are fully supported. The menu at the home was varied and once a month they have a ‘take in’. In the kitchen was fresh fruit, vegetables, pasta and rice - a variety of all types of food. We saw a list of help provided in the kitchen and residents were seen making drinks. They spoke of baking and shopping, take-away food and pub outings. A resident said: “The food is fine”. A resident’s family said: “I’d like more choice in meals”. The Chimes DS0000070223.V369539.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 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are treated as individuals. They get help and support in the way they prefer. Staff know how to give residents the support they need. EVIDENCE: A Community Nurse in regular contact with the home said that staff always seek advice and act on it, health care needs are always met and residents are encouraged to use the same services are ourselves. She says that where one resident refuses to visit a GP the home are helping her to overcome this. She says that privacy and dignity are always respected and individuals are encouraged to respect the privacy of others. A GP felt that sometimes health care issues “drift on”. Records, observation and talking to residents confirmed that routine health care needs are understood and met and residents are always encouraged to take decisions about their health. They are assisted with health care visits only when they wish to be. However, we found that residents are paying for The Chimes DS0000070223.V369539.R01.S.doc Version 5.2 Page 15 regular podiatry/chiropody at the home. The manager said she believed that care staff are not allowed to cut resident’s toenails and so, unless the resident was able and wanted to do it themselves, that was the only option. This is not the case. Where a resident needs treatment for a foot condition, or if there may be a specific medical risk associated with it, this should be sought through the NHS. Where a resident’s only need is normal nail care, the resident should not have to pay unless they wish to do so. The home needs to seek further clarification on this. No resident currently looks after their own medicines but each has an assessment of risk and have consented to staff doing this for them. The manager gave reasons for the level of support provided, one being the level of stress that self medicating had caused a resident. Medicines are kept securely in a locked cupboard within a second locked cupboard. Staff and the manager said that training in handling medication is provided by their pharmacist. The manager said she hopes to increase the level of training so that staff confidence and resident safety are even better met. Medicine records were clear, orderly and informative and staff have good information available to them about the medicines in use. There were one or two gaps in recording of medicines on arrival, and where an entry was hand written a second member of staff should have checked this for safety. We also suggested removing out of date records to reduce the possibility of a mistake. This was done immediately. Currently, except when staff are newly trained in medicines, the manager does not have a system for checking their continued competence. This should be part of on going supervision. The Chimes DS0000070223.V369539.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 good. This judgement has been made using available evidence including a visit to this service. The manager and staff listen to residents’ worries and complaints. EVIDENCE: All residents surveyed said they knew who to speak to if they were not happy saying they would speak to staff, their key worker or Karen the manager. When asked if they knew how to make a complaint the survey responses included: “I can talk to staff”, “I tell Karen the manager” and “If I’m not happy they try and help”. A resident’s family said: “We have never had cause for complaint. We both feel that the Chimes does the very best it can under sometimes difficult circumstances”. The manager reports that it she has received no complaints. The Commission have received no complaints about the home. An allegation of abuse in July 2007 led to adult protection procedures. The manager handled this correctly and residents were protected. Discussion with the manager and a member of staff demonstrated that they had a good understanding of their responsibilities and how to respond to any concerns. All staff have received training in the protection of vulnerable adults. A staff member showed us the ‘whistle blowing’ policy (which tells staff how to respond to any concerns they have). It had the Commission’s contact details within it. The Chimes DS0000070223.V369539.R01.S.doc Version 5.2 Page 17 Advice and assistance was sought when a resident’s behaviour was perceived as aggressive. This led to a good outcome for the resident and others in the home. The Chimes DS0000070223.V369539.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 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Chimes is a safe, clean and comfortable home that meets most needs of residents. EVIDENCE: The Chimes is very conveniently situated being within walking distance of the town centre, bus and rail services. Eight of the residents have single rooms with en-suite toilets and two residents, who have made a conscious choice to do so share a double room. There is only one communal bathroom but some of the residents have en-suite shower facilities so this is adequate for the needs of the home. The residents share a spacious and well-used lounge and dining room. The kitchen is not large but meets the needs of the service users. Wheelchair access to the kitchen is difficult, but possible. The Chimes DS0000070223.V369539.R01.S.doc Version 5.2 Page 19 The garden contains a small lawn, patio, BBQ and seating. There are steps both too it and within it making wheelchair access difficult. The manager said changes are being considered which will provide garden access through the dining room. This will go some way to providing equal opportunity for wheelchair users. The laundry facilities are on the first floor and not at all accessible to service users who use a wheelchair. There has been an ongoing requirement to provide this access. Methods considered were discussed with us. Although there may be some advantage to those proposed changes all agreed that they could also adversely affect the amount of space currently available. The residents agreed that, although being able to use washing machines would be good, they are satisfied for staff to do this and they will continue doing ironing. Bedrooms are very personalised and homely. Residents said they have all they need. Staff talked of some planned redecoration. The home was clean throughout, fresh, light and contained furnishings in good condition. The Chimes DS0000070223.V369539.R01.S.doc Version 5.2 Page 20 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, 35 & 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are enough staff. They have the training they need to help and support people properly. Before staff work at the Chimes they are properly checked to make sure they are safe. The manager makes sure that staff are doing their jobs properly. EVIDENCE: Both the manager and staff confirm that there remains a low turn over of staff at the home, providing consistency and continuity for residents. Residents spoke a lot of their key worker, the person by whom they are most supported at the home. The staff rota showed that there are usually three members of staff on duty during the day in addition to the registered manager. Waking night staff are not employed but two members of staff provide sleep in cover and are available on-call. The Chimes DS0000070223.V369539.R01.S.doc Version 5.2 Page 21 Staff felt there were sufficient numbers of staff on duty at all times although when asked what could be improved a response was “long hours sometimes”. The rota shows that staff are sometimes working consecutive days of 12 hours plus sleep in duties. The manager agreed to review this. The previous recommendation is repeated. There is no indication that residents’ needs are not met, but long hours and tired staff adds risk. Staff receive a satisfactory standard of training including that, which relates directly to the care of people with learning disability. This includes autism, communication, epilepsy and challenging behaviour. The manager says she is also waiting for other specialist training to be modernised and when it is implemented it will be used for the staff. All staff also receive training in the handling of medication, food hygiene, fire safety and first aid. Residents’ families, asked if staff have the right skills and experience said: “As far as we know” and “The staff seem to be caring. I trust they have the skills and experience that is needed”. A G.P. and community nurse said staff usually have the skills and experience adding that they are always willing to ask for advice. The records of some recently recruited staff were examined. These showed that staff are only employed once the necessary checks are done to ensure they’re suitable to work with vulnerable adults. Residents are now part of the team, which interviews potential staff. This gives them to chance to ask questions and be involved in the decision about staff suitability. Staff asked about support and supervision said: “Management are always available. There is no stigma attached to calling them with any questions. We have good support” and “The manager keeps an eye on everything”. Supervision is very much a collaboration with forward planning and input into our training which is person centred to the staff member”. The Chimes DS0000070223.V369539.R01.S.doc Version 5.2 Page 22 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Chimes is managed so that it is a relaxed and safe home for residents. There is not a good enough system for making sure the home keeps improving. EVIDENCE: The manager has achieved the National Vocational Qualification in Management at Level 4. She also holds a professional nursing qualification and is therefore fully qualified to manage a care service. However, she says there is still the need to keep herself updated and look at changes that may have a positive affect on the home. Staff asked about how well the home was run said: “In general very good”. The Chimes DS0000070223.V369539.R01.S.doc Version 5.2 Page 23 Neither residents, their family, staff or other people involved in the home had anything other than positive things to say about the way the home is run. We looked at the way the home checks that the service it delivers is good and looks for ways to continually improve. We found that family and health and social care professionals have their opinion surveyed. Staff confirmed that they and residents have meetings and there was written evidence that the manager makes regular checks within the home. These include the planning of care, the control of infection and food hygiene. Additional information was provided which confirmed that the home now understands the value of quality monitoring of the service it provides. The manager said that all residents have their own named bank account and cards and that some take out their money from the bank on their own and some need assistance. Where residents are able they make their own financial arrangements. Lockable storage was seen within bedrooms for the security of personal items. The people carrier is the home’s own. The manager said that any medical visit or official outings are paid for by the company. For personal outings the residents pay 40 pence per mile. The manager says this is clearly written within the resident’s contract. Most residents have their own bus pass. Pre inspection information provided by the manager states that all of the required and recommended policies and procedures for running the home are in place and that most of them were updated in February of this year. The premises are well maintained and regular maintenance checks are being carried out and recorded. The Chimes DS0000070223.V369539.R01.S.doc Version 5.2 Page 24 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 3 2 3 3 X 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 X 30 3 STAFFING Standard No Score 31 X 32 3 33 2 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 4 15 4 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 2 X 3 X 2 X X 3 X The Chimes DS0000070223.V369539.R01.S.doc Version 5.2 Page 25 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. 1. Standard YA19 Regulation 12(1)(a) Requirement Timescale for action 31/08/07 2. YA39 24 Residents must not expect to pay for podiatry/chiropody where it is not necessary. Where it is necessary, NHS provision should be sought unless the resident chooses not to. 30/09/07 The registered persons must ensure that there is an effective quality assurance/quality monitoring system in place to enable the service users, staff and other stakeholders to contribute to the on-going development of the service. Previous timescale 1/12/06 and 21/06/07 have not been met. The Chimes DS0000070223.V369539.R01.S.doc Version 5.2 Page 26 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 YA20 YA33 Good Practice Recommendations There should be a system in place for routinely checking staff competence in managing medicines on residents’ behalf. To reduce the risk of the care staff becoming overtired, the manager should bring her shift patterns more in line with the guidance contained in the Working Time Directives. This recommendation has been repeated. The Chimes DS0000070223.V369539.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection South West Office Colston 33 33 Colston Avenue Bristol BS1 4UA 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. Extracts may not be used or reproduced without the express permission of CSCI The Chimes DS0000070223.V369539.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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