Inspection on 24/06/08 for The Saplings

This inspection was carried out on 24th June 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 Saplings 01/08/06

Similar services:

2 Perhaver Park

The Vicarage

7 Hyde Road

St George`s

5 Seafield Road

Credence House

Radfords

Trevaylor Manor

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

CARE HOME ADULTS 18-65 The Saplings Wilton Orchard Fons George Taunton Somerset TA1 3JS Lead Inspector Gail Richardson Unannounced Inspection 24th June 2008 09:35 24/06/08 The Saplings DS0000065161.V362731.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 Saplings DS0000065161.V362731.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 Saplings DS0000065161.V362731.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Saplings Address Wilton Orchard Fons George Taunton Somerset TA1 3JS 01823 324832 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) Somerset County Council (LD Services) Mrs Elizabeth Mary Sweeting Care Home 7 Category(ies) of Learning disability (7), Physical disability (7) registration, with number of places The Saplings DS0000065161.V362731.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Registered for one named person over the age of 65 years, as stated in the application letter to vary registration dated 22 November 2005. 14/08/07 Date of last inspection Brief Description of the Service: The Saplings is registered with the Commission for Social Care Inspection to accommodate up to seven people with a learning disability and a physical disability. At the time of the inspection there were seven people living at the home and therefore the home has no vacancies. The registered provider is Somerset County Council (Learning Disabilities Services). The registered manager is Mrs. Liz Sweeting. Mrs. Sweeting has been the manager at the home since it opened in 1992. The home reregistered in March 2006 when the county council (Community Directorate for Learning Disabilities) became the registered provider. The Community Directorate had provided management and staffing at the home since the home originally opened in 1992. The responsible person for the home is Mr. David Dick. The Saplings is a purpose built care home with accommodation on the ground floor. It is situated in a quiet residential area, close to Vivary Park. The Saplings DS0000065161.V362731.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This was an unannounced inspection, which took place over 2 days ( 5 hours) on the 24th June 2008 and 30th June 2008 by Regulation Inspector Gail Richardson. The second day was to enable access to recruitment and health and safety files. A tour of the home took place and all of the bedrooms and all communal areas were seen. There were 7 people currently residing at the home. The inspector spoke to 3 people using the service and 4 members of staff, the Registered Manager was available on the second day of the inspection. The home has provided CSCI with a completed AQAA (Annual Quality Assurance Audit) which was completed by the Manager and gives details of all aspects of the home. As part of this inspection the inspector surveyed the opinions of a random selection of people using the service and their representatives, GP’s, District Nurses and Care Workers. We received 2 completed surveys from relatives/ representatives and 3 surveys from visiting health professionals. The inspector spent time talking to people and staff within the home and as part of the inspection undertook a period of observation using a recognised observation tool. SOFI (Short Observation for Inspection) Records relating to care including 2 care plans, 1 staff file, finances and health and safety records were examined The focus of this inspection visit was to inspect relevant key standards under the CSCI ‘Inspecting for Better Lives 2’ framework. This focuses on outcomes for service users and measures the quality of the service under four general headings. These are; - excellent, good, adequate and poor. The following is a summary of the inspection findings and should be read in conjunction with the whole of the report. The home was offered the opportunity to have an easy read summary of the report, the manager confirmed that this was not required. The Saplings DS0000065161.V362731.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? Appropriate responses have been made following concerns raised by the fire department. The Saplings DS0000065161.V362731.R01.S.doc Version 5.2 Page 7 The homes AQAA states that the home have improved by expansion of the use of photographs to generate more choice/information giving. Photographs were seen to be used in the home for this purpose. Two staff have recently qualified as trainers for moving and handling to ensure that staff are trained and supported to maintain safe practice in this area. At the previous inspection it was recommended that the use of baby monitors as health surveillance devices be reviewed for individual service users on a monthly basis and that the parameters for using the devises in terms of privacy be clearly recorded in the individual’s care and support plan. Supervision of people using the service is now noted within the individual care plans. 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 Saplings DS0000065161.V362731.R01.S.doc Version 5.2 Page 8 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 Saplings DS0000065161.V362731.R01.S.doc Version 5.2 Page 9 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): 1 and 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a detailed and up to date Statement of Purpose and Service User Guide which contains information about the home and services offered. Assessments of individual needs were contained in each care plan. EVIDENCE: Since the last key inspection, the Statement of Purpose and Service User Guide has remained unchanged. Information is produced in accessible formats which include Somerset Total Communication (STC) as well as written English. No new admissions have been undertaken since the last key inspection. The homes AQAA states There is a clear admissions procedure Service Users Guide has a video to back it up Documents are available in other formats such as Total Communication The environment of the home is tailored to the specific needs of the people using the service. Six of the seven bedrooms have the provision of overhead hoist tracking and profiling beds. The bathroom is fitted with a hi-low bath and mobile hoists are available. Five bedrooms have en-suite facilities. The Saplings DS0000065161.V362731.R01.S.doc Version 5.2 Page 10 We were able to see evidence that staff are well trained and that they have the skills to meet the needs of people at the home. It was further evident that staff had a clear understanding of peoples specific lifestyle choices and preferences. The Saplings DS0000065161.V362731.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7, 8, 9, 10Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s care planning procedures are good and provide staff with detailed information about the needs and lifestyle choices of the people living there. People are supported to make decisions about their lives in line with the care planning and risk assessment process. EVIDENCE: We looked at two care plans at this inspection. Both contained very detailed information about all aspects of the assessed needs of the individuals. They clearly identified their preferences and choices of how they wanted their care delivered. This information supports staff to provide and deliver care in a person centred way Each person has a separate file titled ‘my day’ which details all aspects of daily life and includes a record sheet detailing each activity undertaken and how long this lasted for. These records also included self-directed activities. The Saplings DS0000065161.V362731.R01.S.doc Version 5.2 Page 12 Risk assessments were also in place and evidence was seen of the use of a skills development plan to enable the choice of people to be supported in a safe manner. Care plans demonstrated that the individual and/or their representative had been involved in the care planning and review process. And reviews had taken place three monthly or as changes were identified. There was clear documentation of the input of visiting health professionals including the GP and physiotherapist. All records had been regularly reviewed. Each day staff record daily entries for each individual. These were noted to be detailed and informative. We received completed comment cards from 2 healthcare professionals and a GP. Responses included : Care is always extremely good The Saplings seem to work in isolation to the rest of the network. We tend to know less about this particular home and the service users needs The staff team have a lot of experience and provide generally a good service, however as I have said we do have little contact with the home They provide a very friendly. Safe. Supportive environment One person using the service confirmed that they felt that staff looked after them, another stated that he was ‘Well looked after here, the staff are my friends’. As part of the SOFI observation we saw that staff take time to listen to responses of people to enable their choices to be met. Staff interaction was noted to be of a very good standard with positive interaction was noted to be ongoing for all people, throughout the inspection. Staff demonstrate a good understanding of each persons choices but did not presume to know that would be the choice on the day. Time was given to ensure that people could respond and that their choices were acted upon. Interaction between staff and people using the service was particularly reflective of the affection and care demonstrated during both days of the inspection. All records are stored and accessed in accordance with the Data Protection Act 1998 The Saplings DS0000065161.V362731.R01.S.doc Version 5.2 Page 13 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): 11,12,13,14,15,16,17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home provides people with the opportunity to access a wide range of social/leisure activities and people are supported to maintain contact with family and friends. People are involved in menu planning, shopping and some cooking activities. Meal times are a pleasant social activity where choice is encouraged and supported. EVIDENCE: People are supported to access a range of social and recreational activities. On the day of inspection one person was assisted by 2 staff on a day out to ‘Creely Leisure Park’, another was already out for the day, another person went shopping with a staff member and 4 people were supported by staff in a range The Saplings DS0000065161.V362731.R01.S.doc Version 5.2 Page 14 of activities including story telling, reading, access to the garden, music and singing and encouragement in daily tasks including laundry. The home has access to a local day centre 2 days each week and community access by volunteer and befriended agencies. A visitor to the home does a cookery class each week. One person using the service confirmed that ‘ There is a lot going on’. Activities are rotated and everybody goes out over the period of a week. The home has use of a mini bus and regular family contact is maintained where possible. Routines within the home are flexible and tailored to meet the needs of the individual. Each person has a ‘my day plan’ which sets out their plan for the day and includes group or individual activities. We were informed that staffing levels are increased where required, to meet people’s social needs. Care plans contained information about the hobbies/interests of individuals, and about peoples’ family history/contacts and these contained evidence that people are supported to maintain contact with their family and friends in line with their agreed plan of care. The use of baby monitor equipment in bedrooms continues and is recorded within each persons care plans. The garden area is easily accessible and very well maintained. One person has a greenhouse to support their enjoyment of the garden. There is evidence of individual garden pots for each person and wheelchair accessible hanging baskets. On both days of inspection people were seen to be supported to enjoy the garden area. People using the service confirmed that there was a choice for each meal. The main meal of the day is lunch as staff have found people each better at this time. Lunch was a choice of fagots or pie with mashed potato and peas, followed by desert. The meal is served in the dining room and was observed to be a sociable and pleasant experience. People were encouraged and supported to be as independent as possible. People’s choice were the main factor in the development of the menu and people using the service participated in shopping for food. 3 people using the service confirmed that ‘the food is good’ The Saplings DS0000065161.V362731.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18 19 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff are supported to ensure that personal care needs are met in line with each persons agreed plan of care and preferences. The home ensures that people’s healthcare needs are met. The home’s procedures for the management and administration of peoples’ medication are mostly good. EVIDENCE: Care plans examined contained information regarding the person’s needs, abilities and preferences regarding meeting personal care needs. People confirmed that they felt well cared for and that they felt that staff supported them well. We were able to see evidence in the care plans examined that the home supports people to access appropriate healthcare professionals. Each care plan examined contained very detailed information regarding each persons management. These included areas such as mobility and the input of visiting health professionals, nutrition and the development of communication The Saplings DS0000065161.V362731.R01.S.doc Version 5.2 Page 16 skills to identify choice, likes and dislikes. One person has a risk of infection and the home has a stock of antibiotics available in house, the protocol for commencing the medication is clearly recorded for staff to follow. All areas of identified need are cross referenced to the National Minimum Standards. Care plans were seen to be adjusted as needs changed and the requests for further advice and assistance were documented. Staff training records confirmed that staff have sufficient training and skills to support the needs identified. We examined the home’s procedures for the management and administration of people’s medication. All medicines were found to be securely stored with the exception of some creams and eye drops which were stored in the main kitchen fridge. It is recommended that any medication stored in this manner is stored securely to ensure that there is no risk of accidental ingestion. MAR charts contained clear information about directions for the administration of medications. Information was available regarding any prescribed medicines in use and protocols were in place for the use of ‘as required’ medication. One person is receiving nutrition via a PEG feed and this is managed by a visiting service. The administration of the feed is not recorded on the medication administration record but staff confirmed is recorded in the daily record of the persons care plan. We were informed that nobody was currently prescribed any controlled drugs. We were also informed that all staff had received up to date training in the management and administration of medication. Only one staff member has not yet received the training and in the case of that staff member being on duty another staff member may be brought over from an adjacent unit to undertake medication administration. No body at the home self administers any medication The previous inspection identified that when medication had not been administered that a reason for that omission must be recorded. It was noted that at this inspection there were 4 gaps in the record where no reason or coded indicator had been inserted. It is required that the manager must ensure that all staff are aware that this requirement must be met. It is also recommended that all prescribed creams are named and dated when opened and in use to ensure that people are aware of the date for disposal of the cream. The Saplings DS0000065161.V362731.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are supported to raise concerns and the complaints. The home has policies & procedures in place to reduce the risk of harm or abuse to the people using the service. Staff training in abuse awareness has been provided. EVIDENCE: Copies of the complaints procedure are available in the service user guide and one person using the service when asked if they were able to raise any concerns said ‘yes’ and confirmed that they felt comfortable to speak to any staff member. One relative surveys commented ‘I have never needed to raise concerns’, both relatives surveys confirmed that they knew how to make a complaint’. We also looked at policies and procedures in place to reduce the risk of abuse to people using the service. These included whistle blowing, an updated Safeguarding Vulnerable Adults(May 2007), policies related to the acceptance of gifts and the management of challenging behaviour. All policies contained the appropriate information. The home has not received any complaints since the last inspection and no complaints have been raised directly with the Commission. The Saplings DS0000065161.V362731.R01.S.doc Version 5.2 Page 18 We examined records and procedures relating to the management of people’s finances. The home manages small amounts of money on behalf of people in line with their agreed plan of care. Records are made of all transactions and receipts are maintained. Records and balances are audited each day and signed by 2 staff members. There was evidence that staff have received a POVA(Protection of Vulnerable Adults) and CRB ( Criminal Record Bureau) check prior to commencing employment. The Saplings DS0000065161.V362731.R01.S.doc Version 5.2 Page 19 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): 24,25,26,27,28,29,30 Quality in this outcome area good. This judgement has been made using available evidence including a visit to this service. The home provides people with a comfortable and homely environment which is reflective of their personal tastes. Specialist equipment is available which can assist people who have mobility difficulties. The standard of cleanliness is good and the home’s infection control procedures are of a good standard. EVIDENCE: The home is a purpose built bungalow unit which has an open plan design. The lounge area is spacious and there is an adjoining dining room with access from there to a level garden area. The 7 bedrooms were all leading from the main lounge. The Saplings DS0000065161.V362731.R01.S.doc Version 5.2 Page 20 The home also has a sensory room this is also used as a secondary lounge to enable people using the service to have an alternative living space should they want it. All bedrooms are of a good size with hoist tracking in place as required. All people using the service have the facility of locking doors but at present nobody has taken up the option of a key. Some rooms have a door leading directly outside, these doors can be unlocked form the inside but not accessed from outside. 5 bedrooms have en suite facilities and the remaining rooms have access to a bathroom. Some en-suites are shared. The main bathroom has some areas which need re decoration to prevent the risk of cross infection. The manager confirmed that refurbishment of the bathroom is planned in the near future. Overall the home is pleasantly decorated and each persons room appears to be personally decorated to reflect their choices and preferences. The home appeared clean and there was no malodour . Staff were seen to undertake some domestic tasks. They involved people using the service as part of activities of daily living. The laundry has been fitted with a washing machine and there was also disposable gloves and aprons available for staff to ensure appropriate cross infection procedures can be followed. Appropriate hand washing facilities are in place. The homes AQAA states that Chemicals are kept in a locked cupboard away from service users. The laundry door was not locked and chemicals were stored in there. It was noted that there is no wheelchair access to the laundry and any people using the service who are mobile are supported and supervised when mobilising. The Saplings DS0000065161.V362731.R01.S.doc Version 5.2 Page 21 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): 31 32 33 34 35 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staffing levels are set to meet the needs of people using the service. The home follows appropriate staff recruitment procedures. The home ensures that staff are appropriately trained and are regularly supported and supervised. EVIDENCE: On the first day of inspection there were 5 staff on duty, 2 staff were going out on a trip, one staff was taking a person shopping and 2 staff remained at the home. The staff leaving the home did not do so until all people using the service were washed and dressed. Staff confirmed that staffing levels dropped to 3 staff in the afternoon as people did less activities in the afternoon. There were 2 staff available overnight, one staff was awake and one staff slept at the unit and was woken if needed. Staff confirmed that they felt there was sufficient staff available. The Saplings DS0000065161.V362731.R01.S.doc Version 5.2 Page 22 The manager confirmed that there is was a low staff turnover and the homes AQAA states that Rotas show low levels of relief staff and the flexible working of our permanent staff. All staff are issued with a job description which clearly outlines their roles and responsibilities. Signed copies were available in the staff recruitment files examined. Records and staff spoken with confirmed that they received the training needed to enable them to meet the needs of people using the service. We were able to see that, apart from mandatory training, staff had been provided with other specialist training such as epilepsy, equality and diversity and the Mental capacity Act. Staff confirmed that further training is planned for Intensive Interaction Training and Physical Intervention Training. Newly appointed staff complete mandatory training as it becomes available, induction training is undertaken at the home and the period continues for 12 weeks were any additional training needs are identified and appropriate arrangements are made. Induction is in line with the Common Induction Standards. 2 staff at the home have recently completed training to enable them to train staff in moving and handling in house. Some staff have many years of experience available which is utilised to support people using the service. Only one staff has been employed since the last key inspection. The recruitment records examined contained all required information. The registered manager confirmed that whilst she is not always involved in the interviewing and selection process , that applicants always visit the home prior to an interview and she has access to the application form and previous employment history of all applicants. Not all recruitment records are stored at the home but there was evidence that staff have received a POVA(Protection of Vulnerable Adults) and CRB ( Criminal Record Bureau) check prior to commencing employment. We were able to see that supervision sessions are used to discuss a wide range of topics which included the areas outlined in the Nation Minimum Standards. Any training needs are identified, discussed and any action required is recorded. Staff also have an annual appraisal. Staff spoken with were very positive about the support they received, they confirmed that they felt morale was good and that they enjoyed working at the home The Saplings DS0000065161.V362731.R01.S.doc Version 5.2 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37 38 41 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is effectively managed by a registered manager who promotes an open, positive and inclusive style of management. All documents are maintained and stored in line with the Data Protection Act The home has procedures in place to ensure the health and safety of persons at the home. EVIDENCE: There have been no changes to the management structure since the last inspection. The registered manager Liz Sweeting is an experienced and appropriately trained manager who promotes an open, positive and inclusive style of management. Both staff and people using the service told us that she was very supportive and approachable. The Saplings DS0000065161.V362731.R01.S.doc Version 5.2 Page 24 Annual Quality Assurance questionnaires had not been sent since the last inspection and the views of the people using the service and their relative/representatives had not been sought. CSCI Survey comments from relatives were all very positive about the care they observe. Staff meetings are held monthly and minutes are maintained. All documents within the home are stored securely and maintain the confidentiality of people using the service. The home has procedures in place to ensure the health and safety of persons at the home. During this inspection we examined records relating to the following; FIRE SAFETY – We were able to see evidence of weekly in-house checks on the home’s fire alarms and emergency lighting systems. Staff training records indicated that staff had received up to date training in fire safety in the form of a video and quiz. This was last done on 20/03/08. There was also evidence of fire exit checks and an evacuation drill had taken place 19/06/08. A fire risk assessment is in place but not examined at this inspection. ELECTRICAL SAFETY – Hardwiring and Periodic Appliance testing was not available at the home and is to be forwarded to CSCI GAS SAFETY - A gas certificate was not available at the home and is to be forwarded to CSCI EQUIPMENT SERVICING – We were able to see 6 monthly servicing records for the home’s ‘hi-low’ bath and mobile hoist dated 27/03/08. Hot Water Temperatures To reduce the risk of scalding, hot water outlets are checked monthly to ensure that they do not exceed the Health & Safety Executive’s safe upper limits. To reduce the risk of Legionella, weekly flushing is carried out on water outlets not frequently used. The Saplings DS0000065161.V362731.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 X 4 X 5 X 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 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 1 x 3 3 X X 3 3 X The Saplings DS0000065161.V362731.R01.S.doc Version 5.2 Page 26 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA20 Regulation 13 (2) Requirement When a medication is not administered, staff must ensure that a definition is recorded to confirm why this has not taken place. Previous timescale of 12/09/06 not met Timescale for action 29/08/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA20 Good Practice Recommendations It is recommended that all prescribed creams are named and dated when opened for use to ensure that they are disposed of when out of date. It is recommended that medications, which are stored in the kitchen fridge, are stored in a locked container to prevent the risk of accidental ingestion. 2. YA20 The Saplings DS0000065161.V362731.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI The Saplings DS0000065161.V362731.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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