Inspection on 10/05/07 for The Old Rectory

This inspection was carried out on 10th May 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

Other inspections for this house

The Old Rectory 30/03/09

The Old Rectory 15/12/05

The Old Rectory 20/07/05

The Old Rectory 21/02/05

The Old Rectory 12/07/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 The Old Rectory Cromer Road Hevingham Norwich Norfolk NR10 5QU Lead Inspector Mrs Judith Last Key Unannounced 10th May 2007 02:20 The Old Rectory DS0000046151.V339632.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 Old Rectory DS0000046151.V339632.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 Old Rectory DS0000046151.V339632.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Old Rectory Address Cromer Road Hevingham Norwich Norfolk NR10 5QU 01603 279238 F/P 01603 279238 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Susan Jarvis Mr Richard Jarvis Not applicable Care Home 9 Category(ies) of Learning disability (9) registration, with number of places The Old Rectory DS0000046151.V339632.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. A maximum number of nine (9) services users with learning disabilities may be accommodated. 15th December 2005 Date of last inspection Brief Description of the Service: The Old Rectory is a care home providing personal care and accommodation for 9 younger adults with learning disabilities. Mr Richard Jarvis and Mrs Susan Jarvis own the home. Susan Jarvis has the responsibility for the management of the home. The Old Rectory is a Grade II listed Georgian building located on the outskirts of the village of Hevingham, some 8 miles from the City of Norwich. The service users are unable to access amenities independently, but the home is within easy driving distance of the City of Norwich and the market town of Aylsham. The home has had an extension added, to provide comfortable accommodation for the service users. The home has nine bedrooms, eight on the first floor and one on the ground floor. All bedrooms are single and of a good size. The home has various communal areas that provide comfortable accommodation. Outside there are extensive grounds that include a pond and a wooded area. Next to the house there is an enclosed garden for service users to have easy and safe access to. Fees for the service are from £2994.32 to £3044 per month. There are additional charges for private chiropody, hairdressing, toiletries and personal spending, some day care activities and contributions towards transport and the cost of outings. There is also a charge to people for having their accounts independently audited where the manager handles the money. People living at the home will need Mrs Jarvis or the staff to explain inspection reports to them. The Old Rectory DS0000046151.V339632.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Care services are judged against outcome groups. These look at how well a provider delivers outcomes for people using the service. We visited the home without telling Mr or Mrs Jarvis we were coming. We stayed there for six hours and spoke to four people living there, two staff and Mr and Mrs Jarvis. We looked at and listened to some of the things going on in the home. We found out things from the records, including files for four people living at the home and three staff working there. We got some other information from things Mrs Jarvis sent to us before we went, from written comments from four relatives and from two professionals helping to support people. We have put some of the comments people made, into the report. What the service does well: What has improved since the last inspection? There was only one thing the home needed to do at the last inspection. They needed to make sure that staff signed the sheets for recording when they gave tablets straight after they had given them for each person. We were told how tablets are now given and how things are written down. This is now happening. Mr and Mrs Jarvis have continued with decorating rooms that need it, making sure these look nice and are pleasant for people to use. The Old Rectory DS0000046151.V339632.R01.S.doc Version 5.2 Page 6 Staff are good at supporting people to see health professionals who can help keep them well. 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 Old Rectory DS0000046151.V339632.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 Old Rectory DS0000046151.V339632.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. We have made this judgement using a range of evidence, including a visit to this service. People who were thinking of moving into the home would have their needs assessed so that they could be met. EVIDENCE: There is an assessment of people’s needs on each file together with information obtained from other professionals. This covers a wide range of relevant background information as set out in standards. One person told us they had visited the home when there had been an empty room to see if they liked it before they moved in. The Old Rectory DS0000046151.V339632.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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People or their representatives are involved in decisions about their lives, but there is room for improvement in showing the efforts made to encourage their involvement in planning their care. EVIDENCE: There are assessments, individual goal sheets and progress sheets on each person’s file. Progress sheets are updated regularly. Progress towards specific goals could be recorded on the goal setting sheets in the manner they provide for. Daily notes do not always show that the care delivered is what is set out in goal planning sheets or at social services led reviews. However, observation and discussion on the day shows that the things that were supposed to have happened, did. The Old Rectory DS0000046151.V339632.R01.S.doc Version 5.2 Page 10 They could also tell us about some of the signs when people were becoming stressed or anxious and might need particular support. These things matched what was in care plans. This means staff showed us they had a clear understanding of the needs of people they supported. All four relatives told us in comment cards they sent to us that they are always kept up to date with important issues affecting people. They also say the care home always gives the support that they expect or have agreed. One person comments that they do this well beyond the call of duty and that Mrs Jarvis and the staff know the “ins and outs” of each individual resident. People spoken to say they can decide what they do, where and how in the home they spend their time, and how they would like to arrange or decorate their own rooms. There are risk assessments to support where people might have restrictions imposed and in one case another professional has emphasised the importance of a person having firm and set boundaries rather than unrestricted options. Mrs Jarvis says that things are discussed with and explained to people. People who are able to have signed parts of their support plans. However, use of alternative format, (for example, photographs, symbols, tape or objects of reference), is limited. Financial records show that some people manage small amounts of money on a daily basis. Where the manager is involved, there are clear records. We checked three records and entries matched receipts, counterfoils or bank statements. Accounts are audited separately and independently each year and people pay for this. Sometimes Mrs Jarvis will make purchases on service users’ behalf using her credit card. These are clearly shown on records. However, she needs to ensure that no loyalty points or bonuses are accrued to her personally as a result of this. Several recommendations have been made under this section to try to ensure transparency, increase participation, and further promote good practice. The Old Rectory DS0000046151.V339632.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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have lots of very good opportunities for activities with a good focus on events outside the home and staff work hard in this area. However, some improvements can be made in encouraging age appropriate activities, supporting people to participate in day-to-day routines to promote and encourage independent living skills. With these areas developed further outcomes will be at least good. EVIDENCE: Some of these issues overlap with the processes of care planning, communication and consultation with people, commented on in the previous section of the report. The Old Rectory DS0000046151.V339632.R01.S.doc Version 5.2 Page 12 Relatives say in written comments they are pleased with the opportunities open to people to participate in activities outside the home. These activities include visits to shows, coffee mornings, swimming and bowling. People told us they were looking forward to their holiday in June. When we asked if they helped choose the holiday one person told us that they had not decided where they were going, but did not mind that. One person whose file was seen has employment, supported by staff from elsewhere. However, activities and interactions within the home are not always age appropriate. We heard one person called a “good girl” and another being involved in reciting nursery rhymes. When we asked, we were told the person likes this. However, other options need to be explored to encourage the person’s interest in words or rhymes. Three relatives completing comment cards say that the home always supports people to live the lives they choose. One says they usually do this. One file seen shows the person’s reluctance to participate in household routines. However, there is room for showing and recording participation for others who could be encouraged to do so, and in showing the nature and degree of support staff need to offer. Relatives’ comments support that people are encouraged to maintain contact. One person receives regular phone calls, (on the day of the visit and recorded in notes), and people say that they can visit family members. This is also supported in records. Records show that risk assessments have been carried out and reflect that people would find it either too difficult, or would provoke stress and anxiety, in holding keys for their rooms or any locked facility. The kitchen is accessed using a keypad. People told us that they like the food and that they can have something else if they do not want what is offered. The mealtime routine heard was quiet and calm in atmosphere, with gentle conversation between staff and people living at the home. People have their weight monitored regularly and concerns are addressed in care plans, menus, and taken up with other relevant people. Mr and Mrs Jarvis have recorded aims to promote healthy eating and Mrs Jarvis has had training on this. One relative specifically commented in one of our comment cards that people have a well-balanced and fresh diet. The Old Rectory DS0000046151.V339632.R01.S.doc Version 5.2 Page 13 Recommendations have been made under this section to reflect that there is room for improving the appropriateness of activities, and showing, as set out in standards, how people’s skills and abilities are encouraged and developed appropriately. The Old Rectory DS0000046151.V339632.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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care that people receive is based on their individual needs. Guidelines are needed for the administration of “as required” medicines to ensure this is administered consistently and promptly when needed. EVIDENCE: Records show that people have some flexibility in the times they go to bed and get up, depending on what they need to do in their daily activity programmes. Discussion with staff shows that female staff support female service users with their personal care. It is not always possible for male service users to receive assistance from male staff as there are only two, but this happens when it can. People told us that staff are good and that they help them when they need it. Care plans show the support that people need to maintain their personal hygiene and also record where it is difficult to maintain or secure cooperation. Records show people have input from other health professionals. There are records showing appointments with physiotherapists, consultant psychiatrists, The Old Rectory DS0000046151.V339632.R01.S.doc Version 5.2 Page 15 chiropody, dentist and opticians. The outcomes of these and any changes are recorded. One health professional submitting written comments says that the service always seeks advice and acts upon it to manage and improve health care needs. Mrs Jarvis met with another professional during our visit, to discuss how to best develop health action plans. All staff give medication once they have completed training. The two staff on duty told us they had had training. Medication is stored in a locked treatment room in either a locked trolley (secured to the wall) or a locked metal cabinet. There are clear and complete records. One person gave us a clear account of the administration and checking process. We saw records for one person who has medication prescribed for occasional use. The person asked for this at one point during the visit when they knew they were becoming agitated. It was not given and the situation resolved itself with staff support. However, Mrs Jarvis told us there are times when she has felt staff should have administered the medication sooner. Although staff we spoke to had an understanding of the circumstances in which it might be given, there were no agreed written guidelines about its usage. A requirement has been made. Staff told us sometimes lunchtime medication is given later due to daytime activities and any later dose is adjusted to take account of this and to make sure doses are not given too close together. Two people are prescribed lunchtime medication that is managed in this way. A recommendation has been made about this. The Old Rectory DS0000046151.V339632.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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff, the manager and relatives are aware that some people may need support to express their concerns. People or their representatives have access to a robust, effective complaints procedure although awareness of this could be increased. They are protected from abuse. EVIDENCE: People spoken to say that they have not got any complaints. Two people spoken to and able to express their views say that they would talk to staff if they had any worries and that staff would help them. Half of the relatives completing comment cards say they know how to complain. Half do not. There is a procedure setting out what will happen if someone needs to make a complaint and what the stages of the process will be. The complaints procedure is not currently in an accessible format, and the cognitive abilities of many service users may mean it is difficult to understand even if explained. One relative’s comment card expresses the view that Mrs Jarvis and staff would know if someone was not happy about something from the way they reacted. Mrs Jarvis says that she and the staff team know service users well and can tell if they are upset or unhappy about something. Recommendations have been made about this, so that the home can show they make every effort to encourage and support people in their right to complain if they need to. The Old Rectory DS0000046151.V339632.R01.S.doc Version 5.2 Page 17 The manager told us that staff have regular training in awareness of abuse of vulnerable adults with annual updates. This is shown in the training plan and records. There is written guidance in the policy manual and recruitment files show staff are given the General Social Care Council code of practice that also sets out their obligations to report bad practice. The pre-inspection questionnaire shows that half the staff have NVQ qualifications, (and some certificates were seen). This also covers the rights of people, dignity and respect. The policy on restraint was brought in, in April 2002. It was reviewed in November 2006 but without much alteration. Government guidance about this issue was published in July 2002. Mrs Jarvis says it is not used, but we have given information to her since the visit and she has already undertaken to look at the guidance and the policy again. We saw declarations, signed by staff, about confidentiality and also about not accepting gifts, on personnel files. The Old Rectory DS0000046151.V339632.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. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a homely, comfortable and safe environment that is clean and hygienic. EVIDENCE: We looked at the home briefly to ensure it was in good order. Decoration was in good condition and people told us that they were able to choose the colour of their rooms. Rooms reflected the individual interests of their occupants. People used them freely during the course of our visit. One person had a broken chest of drawers, but Mr Jarvis says arrangements are being made for a replacement. One relative told us in a comment card that the home is always warm, comfortable and clean. There were measures in place to promote food hygiene, both in terms of records and training. The Old Rectory DS0000046151.V339632.R01.S.doc Version 5.2 Page 19 There are disposable gloves for staff to use should they be dealing with body fluids and there is a contract in place for the disposal of waste. There are cleaning schedules for staff to follow. There were no unpleasant odours. Staff and the owners are to be commended in their efforts. The Old Rectory DS0000046151.V339632.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 and 36 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff in the home are supported, trained, skilled, and in sufficient numbers to support the people who use the service. There is room for a little improvement in statutory staffing records and training in alternative methods of communication, (or creation of a “total communication environment”), would benefit people living at the home. EVIDENCE: Training records for staff show that there is an ongoing programme of refresher training in first aid, fire training and the protection of vulnerable adults. The pre-inspection information certified by her as correct, discussion with Mrs Jarvis and a sample of records, show half of staff have NVQ qualifications. The Old Rectory DS0000046151.V339632.R01.S.doc Version 5.2 Page 21 Discussion with staff shows that they have a good understanding of the needs for those they support. It is clear from care plans, reviews and discussion that they have supported people to make good progress. Staff told us that they felt they did have time to spend with people that was not taken up solely with routine care tasks and allowed for activities or just conversation and company. Relationships with other professionals, who provide specialist support, are reported in two sets of comments as professional and cooperative. The manager actively works alongside care staff in providing support to people – at times of peak demand, and so is available as a role model, to clarify issues and promote good practice. One person told us they were working towards completion of induction and foundation standards, and evidence of registration for this was seen on staff files. The person felt they were given a good introduction to the work and they were supernumerary when they first started work. This means they were able to understand the needs of people and the support they required before they needed to do this on their own. The training programme is drawn up annually and in line with the “appraisal” year, taking into account what supervisions, staff meetings and appraisals identify staff need. There has not been training in communication to help the team be more creative in how they try to make information accessible and encourage decision-making. A recommendation has been made about this. Recruitment files show that enhanced Criminal Records Bureau (CRB) checks are taken up on people, and Mrs Jarvis has agreed a renewal period with her insurance company. This is good practice. References are also taken up. Either the full CRB or a check against the list for the protection of vulnerable adults are always obtained before people start work based on dates on files. People are supervised until checks are received. The application form does not make clear that a full employment history is needed with written explanation of gaps in dates and reasons for leaving previous care posts. One person had a short gap of one month and no record of why they left their previous care work. (However, a reference had been obtained from this employer.) Mrs Jarvis says that she looks at this at interview’ but the interview notes do not contain the information either. A requirement has been made about these gaps in records. Records show that supervision takes place regularly, generally once each month. Staff confirm this. They say that the manager is approachable and that they can bring ideas for discussion to staff meetings. Records are kept and the agenda on the standard recording form broadly matches standards. The Old Rectory DS0000046151.V339632.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. We have made this judgement using a range of evidence, including a visit to this service. People benefit from a very well run home where their safety and welfare is promoted and where the views of their representatives are taken into account. There is some room for increasing the ways of consulting and communicating with people living at the home, as discussed in other areas of the report. EVIDENCE: The manager is known from previous inspections and registration to be a qualified teacher of people with special needs. She has completed a Masters degree in business administration. She participates, based on discussion in staff meetings, in periodic training, such as in nutrition and healthy eating. The Old Rectory DS0000046151.V339632.R01.S.doc Version 5.2 Page 23 Surveys of relatives were supplied with the pre-inspection questionnaire. These give wholly positive views about the service (as do the four comment cards supplied directly to us). These comments are looked at, together with needs of service users and staff appraisals to develop a “business plan” to determine priority areas to develop during the forthcoming year. This is accessible to all staff so they understand what is going on. Mrs Jarvis speaks with service users on a regular basis, although there may be room to increase the level of involvement in this and communication has been looked at in other parts of this report. A sample of records was checked to do with safety, including food hygiene and fire safety. There are risk assessments as needed. Staff have, based on training records and the training programme, regular updates on fire training, first aid and food hygiene. There is also a health and safety policy statement on file. Moving and handling training is carried out by external trainers. The Old Rectory DS0000046151.V339632.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 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 3 34 2 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 2 12 2 13 3 14 2 15 3 16 2 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x 4 x 3 x x 3 x The Old Rectory DS0000046151.V339632.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA20 Regulation 13.1.b, 13.2 Requirement Guidelines must be agreed with staff and the health professional concerned, about when it is appropriate to administer medication needed in response to behaviour. This is so that the person concerned can receive treatment they need promptly, consistently and appropriately. The manager must make sure she keeps all the statutory staffing records that the amended regulations require, so that she can show the home complies with the law. It will also provide extra evidence of how people are protected by recruitment practices. Timescale for action 15/06/07 2. YA34 19 Sch 2 nos. 4&6 15/06/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA6 Good Practice Recommendations People’s goals are written down but the progress people DS0000046151.V339632.R01.S.doc Version 5.2 Page 26 The Old Rectory 2. YA6 3. YA6 4. YA6 YA7 5. YA7 6. YA7 7. YA7 8. YA14 9. YA14 YA16 10. YA20 11. YA22 make towards achieving each goal should be set out so that it is easier to see that staff are supporting people to achieve them. Where people’s goals for care have been unchanged for a long time, these should be broken down into smaller steps so that staff and people being supported can more easily recognise their achievements and progress. Records staff make of the care they have given need to show that what they have done is what the care plan says they need to do to support people to fully meet their needs. The manager and staff should look at extra ways to communicate with people so that they can show they are making as much effort as possible to support people in planning their care and understanding information. Wherever possible, the manager should encourage people who are able, to sign their financial records when money is given to them to manage, to show how they are involved in managing it. The manager should be clear in the service users guide and in explanation to people or their representatives, the arrangements and charges for auditing their accounts. This is so people (and/or their representatives) can decide whether to pay for the existing arrangements or make their own. The manager should to ensure that, where she spends money on behalf of service users, no loyalty points or bonuses are accrued to her account. This is to make sure that the way transactions are made does not exploit or benefit from people living at the home. The manager and staff should look at ways of monitoring and ensuring their interactions with people are appropriate for people’s ages, in order to help promote people’s dignity, respect and self esteem. The manager and staff should look at ways of developing and tailoring activities that people are interested in so that they are age appropriate as well as reflecting people’s interests. They should take into account opportunities for participating in domestic tasks more frequently. This will help promote or maintain skills and abilities. Where daytime activities mean that giving lunchtime medication is difficult, professional advice should be taken about rescheduling doses or making other arrangements to make sure people receive the medication they need at the times when they need it. The manager should make sure that people’s representatives all have copies of the complaints procedure to remind them what to expect if they have DS0000046151.V339632.R01.S.doc Version 5.2 Page 27 The Old Rectory 12. YA22 13. YA33 YA39 concerns, and so that they can advocate and support people living at the home if they need to. The manager should think about how she can make the complaints procedure more accessible and meaningful for people, so that the service can show how they have tried to help people understand their rights and how to complain if they need to. There should be training and use of alternative methods of communication so that staff are able to make information more accessible and can provide a range of methods to help people express their views or make meaningful choices. The Old Rectory DS0000046151.V339632.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF 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 Old Rectory DS0000046151.V339632.R01.S.doc Version 5.2 Page 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. 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