Inspection on 21/10/08 for The Elms [Stapleton]

This inspection was carried out on 21st October 2008.

CSCI found this care home to be providing an Good service.

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

Other inspections for this house

The Elms [Stapleton] 05/11/07

The Elms [Stapleton] 13/11/06

The Elms [Stapleton] 20/06/06

The Elms [Stapleton] 03/03/06

The Elms [Stapleton] 17/08/05

The Elms [Stapleton] 18/08/04

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 17/02/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: The Elms [Stapleton] Park Road Stapleton Village Bristol BS16 1AA     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Sandra Jones     Date: 2 2 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 29 Information about the care home Name of care home: Address: The Elms [Stapleton] Park Road Stapleton Village Bristol BS16 1AA 01179584506 Telephone number: Fax number: Email address: Provider web address: graeme.reynolds@brandontrust.org Name of registered provider(s): Type of registration: Number of places registered: The Brandon Trust care home 14 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The Home may accommodate 9 named residents whose primary focus of care is their mental health needs. (Registration will revert to Learning Disability (LD) with no additional mental health care needs when these residents leave). The maximum number of service users who can be accommodated is 14 The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: Learning disability (Code LD) Date of last inspection Brief description of the care home The Elms is operated by the Brandon Trust and managed by louis Westlake (not currently registered with CSCI). The purpose of the home is to provide accommodation and personal care for up to fourteen adults with learning disabilities. Within the numbers, nine individuals with learning disabilities for whom mental health care needs is the primary focus of care, are accommodated. The property is situated within its own extensive grounds on Stapleton Village close to shops, bus routes and other amenities. It is arranged over two floors with shared space on the ground floor and bedrooms on both floors. The fees at the home range from £422.55 -£630.68 per week. Care Homes for Adults (18-65 years) Page 4 of 29 14 Over 65 0 Care Homes for Adults (18-65 years) Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is Two Star. This means the people who use this service experience Good quality outcomes. This key inspection was conducted unannounced in October 2008 over two days and focussed on the assessment of key standards. The main purpose of the visit was to check on the welfare of the people who use the service, ensure the premises are well maintianed and to examine health and safety procedures. During the site visit, the records were examined and feedback was sought from individuals and staff. However, inidviduals at the home refused to feedback about the standards of care. Prior to the visit some time was spent examining documentation accumulated since the Care Homes for Adults (18-65 years) Page 6 of 29 previous inspection. Acompleted Annual Quality Assurance Assessment was recieved from the home and this information was used to plan the inspection visit. Have your sa surveys were sent to people living at the home and health care professionals that visit or have input inot the needs of the people living at the home. Two surveys from people living at the home were returned to CSCI in advance of the key inspection. There are nine individuals living at the home and four people were case tracked during the inspection. Case tracking is the method used to assess whether people who use the services receive good quality care that meets their inidviduals needs. The inspection included looking at records such as care plans and reviews of the care of people using the service and other related documents. The homes policies and procedures were also used to confirm the findings. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 29 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is an effective admission process for people to make decisions about moving into the home. THe Statement of Purspose informs people wishing to live at the home about the facilities and services avialable at the home. Evidence: The prepared Statement of Purpose says that the primary value of the home is to provide care, support and accommodation in the community for people with learning disabilities and mental health care needs. The admission procedure is described within the Statement of Purpose and endorses that to ensure the persone needs can be met at the home, a process that includes assessments, introductory visits and trial periods is followed. There is an in-house admission procedure which supplements the procedure described in the Statement of Purpose. Both procedures must be reviewed to clarify the assessments that will be conducted to ensure the staff have the skills to meet the Care Homes for Adults (18-65 years) Page 10 of 29 Evidence: persons needs In addition the Statement of Purpose would benefit from up dating information about the criteria for admisssion and range of needs that can be met at the home. Once the information is updated, people wishing to live at the home can make informed decisions about the services and facilities available at the home. There is one vacancy and the manager said that they are actively seeking to fill the vacancy. Care Homes for Adults (18-65 years) Page 11 of 29 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Individuals at the home are able to achieve independant lifestyles through the effective care planning process. People are empowered to make decisions and risks are assessed. Evidence: Each person at the home has a Planning for Life Case file that contains personal details, background history and contract agreements. The needs of the people at the home were reviewed within the last twelve months by the social worker and the Adult Community Care Reviews that ensure their changing needs can be met by the staff are kept on file. Care plans list the assessed need and support plans detail the action that must be taken to meet the assessed need. Support plans are detailed and guide the staff to consisitently meet the need identified. It is evident from the support plans that a person centred approach to meeting needs is used. For example, the preferred Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: routines, likes and their abilities to meet the need is described within the support plan. Generally, support plans are up to date and signed by the person indicating their agreement with the plan of action. Monthly summaries are completed by the keyworker and report on the progress of the care plan. Staff giving feedback about the care planning process said that there is a keyworker system in operation and the role includes 1:1 time with designated people at the home, shopping and supporting people to maintain their bedroom tidy. In terms of care plans staff said that there is an expectation that they keep up to date with the information and use daily records to report events. Risk assessments are developed for inidviduals that at times exhibit aggressive and violent behaviours. Through the strategy, members of staff are guided on the actions to be taken to reduce potentially aggressive and violent sitautions. There is a clear approach within the strategies towards respecting inidvdiuals rights. Reports about the behaviour exhibited are completed following an incident to ensure the strategies in place reduce the level of risk to the person, the property and other people living at the home. Positive behaviour strategies are in place to support people with sleeping patterns and personal care, agreements are signed by the person to show their agreement with the action plan. The framewrok of acceptable actions ensure that the action that can be taken by the staff are not punitive. Following violent and aggressive incidents staff complete an ABC chart so that triggers can be identified and used to updated the strategy. However, the charts are not currently used to update the risk assessments. For the ABC charts to fulfill thier purpose the information must be used to update strategies for people that exhibit aggressive and violent behaviours. Communications form part of the care plan and specified are the inidviduals ability to communicate. There is a communication profile for one person which specifies information about the way informed decisions are made. It describes verbal communication and/or actions to be taken, with an interpretation of the persons behaviour on the actions to be taken. Risk assessments are developed for activities that may involve an element of risk. Constraints, factors and options are stated with the actions to be taken to reduce the level of risk. Care Homes for Adults (18-65 years) Page 13 of 29 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are able to make choices about their lifestyle, and are helped to develop their life skills. Support systems in place fensure that people at the home interesting lifestyles and to be valued members of the community. Evidence: Support with leisure and recreational activities form part of the care planning process, A sernior support worker said that person centred plans in terms of goals and aspirations are being devised and are at various points of completion. Goals and apsitiations plans include monthly outiging, paid employment, educations and day care services. Progress notes describe the actions to be taken to meet the goals and monthly checklist completed by the keyworker monitor that in-house and community based activities occur in line with the plan. Care Homes for Adults (18-65 years) Page 14 of 29 Evidence: Staff at the home were consulted about the opportunities available for personal development. The staff said that individuals wishes and aspirations are sought and from the information provided, a plan is developed on the way they are to be met. The people living at the home use the grounds, they will walk around the grounds and watch cricket games in the adjacent fields. Staff said that three people will leave the home and can independently use community facilties. One person chooses not to leave the grounds and another needs assistance because of mobility needs. The staff said that the people at the home use the Local Health Centre, public transport, pubs and skittles. Surveys from two people at the home were received. One stated that they never make decisions about what to do each day and one person said this was sometimes. It was furhter indicated that they are able to do what they want during the day, the eveneing and at weekendes. Another person stated that they can do what they want in the evening and at weekends but not during the day. Three people have spiritual needs and monthly meetings where bible reading, signing and spritual education take place at the home and facilitated by a spiritual leader. The visitors policy is included in the Statement of Purpose and its open between 9:00 am-9:00 pm. Visitors are welcome in communal areas with the agreement of the people in the area. Where maintaining relationships with family and friends is important to the person, the need is identified through the care planning system of the home. Recognising that maintaining links with family and friends is important. It is not an expectation at present for people to contribute towards the household chores of the home. The manager siad that future plans are that ancillary staff will maintain communal areas and individuals mainaitn their private space clean. This is a positive move towards ensuring that people at the home develop independant living skills. While there is a Privacy and Dignity policy, it is not currently appended onto the homes Statement of Purpose. It states the approach followed at the home and provides examples of the way staff ensure that the rights of the people at the home are respected. Confirmed through the policy that people at the home can raise concers if they are not satisfied. This policy must be added to the Statement of Purpose to fully inform inidviduals wishing to live at the home about their rights. Staff were consulted about the way people at the home are respected as individuals. It Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: was stated that respecting peoples wishes, knowing their likes and dislikes and knocking on doors were ways staff respect the rights of people at the home. The home has a four week rolling menu devised with people at the home, senior staff and the cook. The daily menus are in pictures and words and are on display in the dining area which show that three meals are served. There is a standard breakfast, a light lunch and choice of main evening meal. The range of fresh, frozen and tinned foods confirmed that people have a varied diet. At a recent Food Safety inspection the home was awarded 4 Star for their standards of food hygeine. Care Homes for Adults (18-65 years) Page 16 of 29 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People at the home can expect sensitive and prompt support for their personal and health care needs from a skilled staff team. Medication systems are safe. Evidence: Individuals personal care needs form part of the care plan, their prefered routines, likes and abilities are included in the action plan. This guidance is specific and will enable staff to meet the identified need. A member of staff giving feedback about personal and health care said that it is keyworkers that will generally assist with personal care. It was expalined that staffing rotas are arranged so that keyworkers assist people with their desired routine. Health care files are seperate from Planning for Life files and contain essential medical information. Medical historys, routines and appointments are included with reports from health care professional and monthly summaries from staff. A record of health care visits are maintained and details of the visit with the outcome is recorded. Monthly summaries report the inidviduals health care needs, visits and outcome of Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: appointments conducted the pervious month. Documentation in place supports that people access NHS facilities and include regular visits to the dentist, optician and chiropodist. Staff giving feedback about health and personal care said that people at the home have annual input through reviews from a psychiatrist. It was also explained that communications books and handovers ensure that medical advise is followed consistently. Documentation in place for one person stated that medication is recommended for medical visits in particular dental appointements. Where the personss capacity to make decisions arise, the manager must ensure that best interest decisions are made with the support of health care professional and advocate. Medications are administered through a monitored dosage system, staff sign the records after administaring medicaitons and use codes to indicate medicaitons not administered. Medication profiles specify the individuals prefered times to have medicaitons and the place, for example, breakfast medication to be administered in the bedroom. The purpose of the prescribed medication, the side effects and protocols for when required medications are detailed in the profiles. Homely remedies are administered from a stock suppoly when required and records of administration were found up to date and accurate. A record of medications no longer required is maintained which is signed by the pharmacist to indicate receipt of the medication for disposal. Care Homes for Adults (18-65 years) Page 18 of 29 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home can expect their concerns to be listened to and to be protected from abuse. Evidence: A record of Complaints received is maintained at the home and described are the actions to be taken and the outcome of the complaint. Since the lst inspection a significant number of complaints were made about one person living at the home and the complaints were resolved once the person moved from the home. Other complaints recived are from people at the home about other people also living at the home. The manager has taken appropriate action to resolve complaints and where appropriate has referred incidents to Safeguarding Adults. It was noted that a member of staff raised concerns to a GPs practice on behalf of a person living at the home. While staff acted appropariately by raising concerns about services received on behalf of one person living at the home, the outcome remains outstanding. In recording the concern in the complaints log, the complaints procedure would have been followed and the manager would have ensured that a response was received within a given timescale. Comments about making complaints were received from two individuals through Have your say surveys. One person said that they know who to approac if they are not Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: happy and how to make a complaint. Another person siad that they did not know who to approach if they are unhappy or how to make a complaint. The Trust Safeguarding Adults, Whislte Blowing and Equalities procedure show a commitment towards safeguarding people from abuse. Staff said that there are no outstanding referrals. Staff were consulted during the inspection about the way individuals are supported to make complaints. It was stated that concerns raised by the people at the home must be logged and the information is then passed to the manager. This member of staff also said that the investigation and outcome would be checked to ensure the complaint is resolved to satisfactory outcome. Regarding their responsibilities towards safeguarding people from abuse, staff knew the factors of abuse and the actions to be taken for alledged abuse. This member of staff reinforced their responsibility by saying Nobody is here to be abused. Care Homes for Adults (18-65 years) Page 20 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a homely, safe and clean environment that meets peoples care needs; there are still areas that need to be redecorated and refurbished. Evidence: The Elms is a large period property set in its own grounds within a village environment. It is close to amenities, shops and bus routes. Accommodation is arranged over two floors with shared space on the ground floor and bedrooms on both floors. Western Challenge, a housing organisation, currently owns the property. The home has continued to make improvements to both the decoration and refurbishment of the home. Since the last inspection the entrance hall, downstairs corridor and lounge was repainted, and the flooring in the foyer and lounge replaced. This has helped the general appearance of the home in looking spacious and clean. Art work made by the people at the home are on display in the corridor and lounge of the home showing that there is a homely atmosphere. There are two lounges in the past one was used by people that smoke but an organisational decision has now been made for people to smoke outside. The second Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: lounge is used more as a quiet room. The designated smoking area is now outside within a courtyard. The dining room is spacious and has enough tables for people to sit comfortably; some people were seen during the lunchtime meal choosing to sit on their own. Not all bedrooms were seen but those that were shown to be decorated as people wanted, and displayed their personal belongings. Some people have had new furniture and flooring fitted since the last visit. The home has enough toilets and bathrooms for people to use. Two people made comments about the environment through surveys. One person said that the home was always fresh and clean and commented I sometimes help. Another person said that the home was sometimes fresh and clean. The laundry is a separate area, there are two domestic washing machines and one tumble dryer. Care Homes for Adults (18-65 years) Page 22 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported by a competent, qualified and skilled staff team who are well supervised. Evidence: Personnel files are held at the Brandon Trust office, and employment record sheets are kept at the home. Employment record sheets are used at the home to evidence that the manager saw Criminal Records Bureau (CRB) checks and references. Also included are staffs personal and employment details, supporting that there is a robust recruitment process in place. There is a Trust Learning adn Development programme and each member of staff is given the opportunity to select between 4-5 courses to attend per year. Senior staff said that training courses must be applicable to the role and statutory training is in addition to the courses selected. For example, autism training, Mental Capacity Act and Mental Health and Learning Disability training. Senior staff said that there is a Trust Induction and new staff must complete the LDQ to ensure that staff have insight into the needs of the people at the home. Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: Staff consulted about training confirmed that training that meets the changing needs of the people at the home and for thier personal developement is encouraged. Care Homes for Adults (18-65 years) Page 24 of 29 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit generally from a well run home with their views listened to. There are processes to monitor health and safety to ensure people are safe. Evidence: Staffs feedback was sought about the way the home operates and consistency of care is maintained. One member of staff said that communication is essential and well done at the home, it was said that staff look up information, follow-up information and check out informaiton. Regarding consistency of work, it was stated that the following systems ensure consistency. Handovers occur during shift changes, staff meetings are convened monthly and individual supervision is monthly. Survey comments were received from two people about the staffing at the home. Both people said that they are always treated well by the staff and they always listen and act on what they say. Fourteen staff are employed at the home and the rota shows that the manager works Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: supernummary twice weekly and is hands on for other shifts. Three staff are rostered to work in the morning and in the afternoon the staffing levels reduce by one. At night one member of staff sleeps-in and one is awake. Ancillary and cooking staff are employed to cook and keep the home clean. Senior staff said that there are 60 vacant hours and plans are in place to cover vacant hours. It was further stated that while recruitment is taking place vacant hours are being covered by bank staff. Facilities for the safekeeping of cash and valuables exist at the home. Records of cash cecked coresponded with the balances of cash held on behalf of the people at the home. Fire risk assessments are undertaken and through the assessment the potential for an outbreak of fire is considered to then introduce preventative measure to reduce the level of risk. The manager also ensures that the home coplies with other Health & Safety legislation. Annual checks of portable electical equiptment, gas boiler and light conductor are undertaken by outside contractors. The homes Quality Assurrance system is sectioned into core National Minimum Standards (NMS) and Registered Services. A scoring system is used for each standard and where there is a low score an action plan is devised to improve the score. Care Homes for Adults (18-65 years) Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action 1 24 23 (2) Decorate staircase walls leading to staff sleep in room. 30/04/2008 2 24 23 (2) Decorate and replace flooring 30/04/2008 in the lounge that was once the smoking room. Care Homes for Adults (18-65 years) Page 27 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 20 12 The registered perosn shall so far as practicable enable service users to make dicisions with respect to the care they are to receive and their health and welfare. The manager must ensure that where best interst decisions have to be made support from advocates and health care professional are sought. 16/01/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 1 The Statement of Purpose must be reviewed to ensure that information is up to date and fully informs people wishing to live at the home about the services and facilities offered at the home. For the ABC charts to fulfill their purpose the information must be used to update strategies for people that exhibit aggressive and violent behaviours. 2 6 Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 29 of 29 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!