Inspection on 22/05/07 for The Firs

This inspection was carried out on 22nd May 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

The Firs 20/12/05

The Firs 30/06/05

The Firs 18/01/05

The Firs 01/11/04

Similar services:

Flint House

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

The Cotswold Home

Fairways

Treloar College

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

CARE HOME ADULTS 18-65 The Firs Ravenswood Village Nine Mile Ride Crowthorne Berkshire RG45 6BQ Lead Inspector Kerry Kingston Unannounced Inspection 22nd May 2007 11:00 The Firs DS0000033978.V333306.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 Firs DS0000033978.V333306.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 Firs DS0000033978.V333306.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Firs Address Ravenswood Village Nine Mile Ride Crowthorne Berkshire RG45 6BQ 01344 755580 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) bucketsandspades@norwood.org.uk Norwood Ravenswood Ltd T/A Norwood Mr Ernesto Paulo Pantaleao Cartaxo Care Home 11 Category(ies) of Learning disability (11), Physical disability (11) registration, with number of places The Firs DS0000033978.V333306.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th December 2005 Brief Description of the Service: The Firs provides care and accommodation for up to eleven people with moderate and complex learning disabilities, and is situated within Norwood Ravenswood Village. Ravenswood Village is a community setting providing care and accommodation within individually managed group homes to people who have a learning disability. The Firs aims to provide high-quality care that will maximise people’s personal development and develop a strong sense of religious and cultural identity. The home is a detached two-storey building with eleven single rooms, a large communal lounge, dining room, activities room and kitchen that is furnished to a high standard. There is a two bedroomed ground floor flat at one end of the building and a bedroom with a separate bathroom facility on the first floor. There is a village shop and community hall within Ravenswood where various clubs for the service users are held. Ravenswood owns their own vehicles that assist service users to access services outside of Ravenswood. Public transport is not readily available within the village, but the village of Crowthorne and towns of Wokingham, Bracknell and Reading are within a short drive. The Fees are £47,483 to £63,943 per annum. The Firs DS0000033978.V333306.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine unannounced site visit which took place between the hours of 11.00am and 6.00pm on the 22nd of May 2007, to collect additional information to inform the report for the key inspection. The information was collected from a pre-inspection questionnaire completed by the manager, surveys were sent to people who use the service, other professionals and families of residents, but only one phone call was received in response. Discussions with two staff members, the senior staff member on duty and four people who use the service took place. There was further communication with and observation of other people and staff during the course of the visit. A tour of the home and reviewing service user and other records was also used to collect information on the day of the visit. The home has excellent outcomes for service users in several areas. What the service does well: People who use the service have care plans to make sure that staff can help them in the right way and all their needs are properly met. The staff make sure that residents know all about their care plans and what they think about them. The home makes sure that people can do as much for themselves as possible, as safely as they can. People have plenty of activities that they can choose to do during the daytime and in the evenings. People are treated with respect and dignity and staff listen to what they have to say. People are helped to look after themselves properly and they go to the doctors or the specialist when they are not well. Staff make sure that people who live in the home can tell someone if they are not happy, and something gets done about it. The Firs DS0000033978.V333306.R01.S.doc Version 5.2 Page 6 Staff are well trained so that they know how to look after people properly and they do it very well. 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 Firs DS0000033978.V333306.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 Firs DS0000033978.V333306.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. People who use the service experience good quality outcomes in this area. The service would follow the admissions policy and procedure if any new people were coming to live in the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There have been no new admissions since the last inspection. The home has an admissions policy and procedure that would be used if there were to be an admission. The home has no vacancies. The Firs DS0000033978.V333306.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 and 9. People who use the service experience excellent quality outcomes in this area. The home makes sure people know their assessed and changing needs by encouraging them to be involved in the care planning process. People are encouraged to make as many decisions and choices for themselves as possible. They are supported to lead as independent a lifestyle as possible by using robust risk assessments and regularly reviewing the needs and wants of the individual. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service user plans for four people were looked at. Tthey were excellent, clear care plans and include personal care, cultural issues, relationships and sexuality and normal routines . There are also several documents that note that complaints, medication, door keys and bedroom furniture have been discussed/explained to residents, and their reaction to the subjects. If they are able, they have signed them with their decision/choice. The Firs DS0000033978.V333306.R01.S.doc Version 5.2 Page 10 Care plans are reviewed monthly by the keyworker and a monthly report is written. These are discussed in a monthly meeting between the keyworker and the resident and include a review of all headings in the care plan, and additionally review the needs/wants of the resident for the coming year. Annual reviews note long and short term goals and are signed by residents. Individuals have a copy of their care plan in symbols and pictures or a suitable format. People are as involved in the care planning as possible and their involvement is noted on the plans. Individual Personal Planning meeting notes are produced in symbols/pictures and simple language. People said that they go to their reviews if they want to. There are excellent risk assessments/care guidelines so that the residents are enabled to do as much as they can for themselves, as safely as possible. Resident meetings are held monthly and minutes are produced. The content is focussed on daily routines and menu planning. There was a discussion about including policy and information in future. The village has a residents forum and the home has one resident who represents it, and attends the committee meeting every other week. The resident told me how they were invovled and seemed proud to represent the other people in the home. They said they talk about everything going on in the village and raise money for it. An advocate is available on site, on a drop-in basis, if people have the need to talk to someone ‘outside’ of their daily contacts. People in the home are able to verbally communicate and most are able to advocate for themselves. The Firs DS0000033978.V333306.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, 15, 16 and 17. People who use the service experience excellent quality outcomes in this area. People are supported to live a rewarding and fulfilling lifestyle by being given the opportunity to access a variety of activities, participate in holidays and special occasions and retain important relationships. They are offered a healthy diet and choice about where and what they eat. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Three residents’ activity programmes were seen. All had a programme of activities that had been agreed between them and their keyworker in October 2006. Programmes are reviewed in the summer and changes occur as activities develop. The organisation is working on developing more opportunities for work experience. The Firs DS0000033978.V333306.R01.S.doc Version 5.2 Page 12 Daily notes confirmed that the activity programmes are followed, but people can make choices about whether to attend or not. One service user said she chooses to go on day trips instead of holidays, as she doesnt like to be away from home overnight. She does the post and goes bowling in Bracknell A resident told me she ‘helps do her own washing, cleaning and domestic chores. She has plenty to do.’ Another person discussed her coming birthday and the arrangements the staff are helping her make to celebrate it, for example a trip on the bus, making a cake and a party. They also said how much they like participating in the Special Olympics’. They were very disappointed as they were unable to attend that afternoon because the village was celebrating a Jewish festival and at these times residents are unable to access transport. A non-Jewish person said that they are able to go to church on Sundays and they are able to choose what they want to do. They have ‘plenty to do and never get bored’. They also talked about holiday plans for this year. It was clear that residents choose holidays that offer activities that they are interested in. Three people told me that they go to the local pub, go shopping in the local towns and go to clubs in Bracknell. Most people have contact with family members and friends, and befrienders are found if contact with families is limited or diminishes. The home has overseas students and volunteers who act as befrienders and support people to access daily and leisure activities. Families are invited to attend barbeques and some social events throughout the year. They are invited to reviews and kept up-to-date with their family member’s care, as appropriate. Many of the residents visit the family home on a regular basis. The Service User Guide notes people’s rights and responsibilities, and there was evidence that this was discussed on occasion in the residents’ meetings. Part of the induction focuses on this area and asks for a written response from staff as to how they ensure people’s dignity, rights and responsibilities. Staff were observed to be treating residents with great respect and listening to their views. Residents were very comfortable to challenge staff and make their views known. There was some unhappiness that normal activities could not take place because of the Jewish festival. This was clearly expressed by three residents, and it is an issue that the staff team are mindful of. The Firs DS0000033978.V333306.R01.S.doc Version 5.2 Page 13 People choose where they have their main meal. Many of them like to eat in the main hall as they find it a social environment and have friends from other houses who they are able to meet up with. Food is prepared in the house if residents choose to eat at home. On the day of the visit lunch was prepared in the house and the evening meal was being prepared in the main hall to celebrate the Holy day. Menus were of a good quality, chosen by residents, and there was plenty of choice. The meal was sociable with staff responding to people’s needs/requests sensitively and efficiently. One person said, Ive lived here a long time, its fantastic’. Another said, I like living here. Other comments were, Im happy, and, Im very happy here, I help with the cooking and I like the food. The Firs DS0000033978.V333306.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 People who use the service experience excellent quality outcomes in this area. People are supported to look after their health, emotional and personal care needs by staff involving them in care planning and assisting them to understand any health care issues they may have. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The four care plans seen included personal care, cultural issues, religious needs, healthcare, behaviour, people’s likes/dislikes and how staff can help them to make choices and decisions. The care plans note the way staff should approach people and describe how they ensure their dignity, and how they treat them with respect and allow them to make their own decisions. Care plans are reviewed monthly by the keyworker and the resident. Behavioural strategies are agreed and signed by individuals so that they know how they are going to be helped with their behaviour. The Firs DS0000033978.V333306.R01.S.doc Version 5.2 Page 15 Guidelines for one person who has, occasionally, extreme behaviour were not available but it was clear that they were in place as reference was made to them being amended. The senior staff member agreed that she would address this issue immediately. People’s cultural, religious and diversity needs are adressed by individual care plans and the home’s focus on meeting the needs of individual residents. Female residents have accomodation which includes seperate bathroom facilities from the male residents. They are very comfortable with this. One parent said she was delighted with the care given to her son. Excellent health care records are inlcuded in the care plans. There are annual medication reviews and dentist, chiropodist, optician and specialist/GP appointments. Each individual has an OK health check summary, that is information to take with them to the doctor or hospital to assist them to express themselves. All residents have health checks appropriate to their age, gender and medical condition. The medication is kept in a locked cupboard and is given by two staff whenever possible. A staff member is nominated as responsible for medication administration on each shift. Staff said that this system is working very effectively. There is a robust procedure and very clear instructions are prominently displayed in the appropriate places. The senior staff member said that there are very few errors, and none have been noted this year. Records seen were accurate. Individuals have a record noting their medication, any medication to be given as required and how people preferred their medication to be given, and these included photographs. It was discussed that a more detailed description of behaviours that cause staff to give medication to help behavioural control would be beneficial. Residents’ permission is sought before any ‘as required’ medication is given. Staff do not give medication until they are trained in medication administration and assessed as competent by senior staff. Two staff confirmed that they had received medication administration training and that they receive refreshers and annual competence assessments. Senior staff check residents medication files weekly and the pharmacist checks all medication administartion records, approximately six monthly (the last check was recorded in September 2006). A medication delivery was observed. Staff carefully checked in all medication from the weekly delivery by the local pharmacy. The Firs DS0000033978.V333306.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. People who use the service experience excellent quality outcomes in this area. The home protects people from all forms of abuse and listens and acts upon what they say. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Two complaints have been recorded since the last inspection and these have been appropriately dealt with. There have been no safeguarding adults investigations or issues recorded, and the senior staff member confirmed that there had been no concerns in this area. The complaints procedure is in a service user friendly format. Four people told me who they would talk to if they were not happy, and two said that the staff would help them. The Commission for Social Care Inspection has received no information with regard to complaints or safeguarding adults issues. Two people said that staff listen to them and help them, they act on what they say and they feel safe in the home. The Firs DS0000033978.V333306.R01.S.doc Version 5.2 Page 17 Three staff spoken to were very clear about how they would protect people in their care. One staff had only been in post for three weeks but she clearly, described her responsibilities with regard to the protection of residents. All staff have protection of vulnerable adults training and updates as necessary. Senior staff do advanced training and the manager of the home is the protection of vulnerable adults co-ordinator for the village. Residents have access to an advocate who holds drop-in surgeries in the coffee shop for anyone who needs someone to talk to, outside of the home. Many of the residents in the home are articulate and able to advocate for themselves. One person was very comfortable to tell staff that they were unhappy that their favourite cereal had not been purchased on the day. Staff responded to these concerns immediately and told them what they were going to do about it. One incident of restraint was recorded but the type of restraint was not detailed. Guidelines for the use of restraint for the individual were not available but had been read by two staff spoken to. The senior staff member on duty said that she would make sure the guidelines were available. Residents’ finances are well recorded, and there is a very robust financial procedure to ensure the safety of residents’ monies. The home recieves a monthly breakdown of residents’ income and their contribution to their care. It was discussed that adding this information to people’s contracts/statements of terms and conditions would be good practice. The Firs DS0000033978.V333306.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 and 30. People who use the service experience good quality outcomes in this area. The home is comfortable, clean and hygienic. People who live there are encouraged to take ownership of their environment and are proud of their home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is well cared for and was very clean and hygienic on the day of the visit. Residents are involved in the cleaning rotas and have ownership of their environment. There are some areas that need need attention, such as cracks in the wall in the activity room (the den). The home has good quality and comfotable furnishings and fittings. The Firs DS0000033978.V333306.R01.S.doc Version 5.2 Page 19 Bedrooms are individualised, reflecting people’s tastes and personalities. The three female residents have their own bathing/toiletting facilities. The kitchen and bathrooms are very clean and the laundry is well organised. People help with their own laundry. The Firs DS0000033978.V333306.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, 34 and 35. People who use the service experience excellent quality outcomes in this area. The people who use the service are supported by a qualified and competent staff team who understand their needs and are able to communicate effectively with them. Staff are recruited safely by the use of robust recruitment and induction procedures. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has appointed no new staff since the last inspection. The last two staff to join the team transferred from another house in the village. One staff member has been transferred as part of a devlopment programme to enhance her knowledge and skills in managerial aspects of the work. Other new staff are overseas staff pursuing their induction programme. The organisation follows the same recruitment procedures for all staff recruited overseas. Elven of the thirteen staff are qualified to NVQ 2 or above. The Firs DS0000033978.V333306.R01.S.doc Version 5.2 Page 21 The minimum staff per shift (daytime hours) is three, but the home generally operates with four staff in the morning and three in the afternoon. There is one waking night staff and one person sleeping-in to offer support if necessary. Peole said, I like all the staff, I talk to staff, theres nothing Id want to change, I love the staff, theyre all good staff, I would talk to staff if Im not happy. Staff were observed interacting respectfully and sensitively with residents. People were obviously comfortable discussing their daily and longer term issues with them. Training opportunities are numerous and include regular updates of all mandatory training, basic health and safety training, specialist training to meet the needs of people in the home such as epilepsy and challenging behaviour and developmental training for staff such as supervision and assertiveness. One staff member described her development plans which included a training period to be a senior (Grade A). Supervisions are held regularly, monthly if possible, and appraisals have been almost completed for this year. Staff meetings are held two-weekly and minutes evidenced good content such as passing of information, discussion of practice issues and the needs of individual service users. One staff member said she feels supported, is being taught a lot and was able to clearly outline her safeguarding adults responsibilities and her induction content. The induction includes written questions and responses from inductees which are discussed with supervisors and form part of the staff member’s development plan. Work is being undertaken to update individual training records. Volunteers and overseas students are recruited by the volunteer co-ordinator for the village. The volunteers usually have the role of befriender to an individual and the students have a job description that precludes personal care. Tthey offer extra support for activities and leisure. The same checks are used for volunteers as for staff (advised by line manager). Some residents are currently involved in a training programme to enable them to become more involved in the the recruitment process. The Firs DS0000033978.V333306.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 and 42. People who use the service experience good quality outcomes in this area. The home is well managed and the health and safety of residents is a priority in the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The homes manager is experienced and keeps his knowledge up-to-date, attending eight training courses in 2006. He has completed the Registered Managers Award. Staff said e is supportive and residents said they like him. There are several quality assurance systems in place. These consist of checks on the home by managers from other homes, weekly checks on areas such as medication, finances, health and safety, regular Regulation 26 visits and lay assessors visits to the home. The Firs DS0000033978.V333306.R01.S.doc Version 5.2 Page 23 The last lay assessors visit was in March 2007 and this resulted in a very positive report. The home also responds to comments made by the people who use the service, in resident meetings and the residents’ committee. There is not an annual devpelopment plan in place but there is evidence of developmental work being done such as improving training and other records. Health and safety is checked weekly and maintenance records are up-to-date. Incident/accident forms are audited monthly by senior staff and action is taken as necessary. An external health and safety audit took place in August 2006 and all the recommendations were complied with. The Firs DS0000033978.V333306.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 X 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 4 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 4 33 X 34 3 35 4 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 X 4 X LIFESTYLES Standard No Score 11 X 12 4 13 3 14 X 15 3 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 4 3 X 3 X 3 X X 3 X The Firs DS0000033978.V333306.R01.S.doc Version 5.2 Page 25 NONE Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations The Firs DS0000033978.V333306.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Oxford Office Burgner House 4630 Kingsgate Oxford Business Park South Cowley, Oxford OX4 2SU 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 Firs DS0000033978.V333306.R01.S.doc Version 5.2 Page 27 - 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. 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