Inspection on 31/10/07 for Twyford Lane (7)

This inspection was carried out on 31st October 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 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

Twyford Lane (7) 17/12/09

Twyford Lane (7) 13/11/06

Twyford Lane (7) 16/12/05

Twyford Lane (7) 25/06/05

Twyford Lane (7) 29/09/04

Twyford Lane (7) 23/05/04

Similar services:

Flint House

The Cotswold Home

Fairways

Treloar College

Rush Court

The Maypole Nursing Centre

Fir Tree Lodge

Chilmington House

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

CARE HOME ADULTS 18-65 Twyford Lane (7) 7 Twyford Lane Browns Wood Milton Keynes Bucks MK7 8DE Lead Inspector Andy McGuckin Unannounced Inspection 31st October 2007 09:30 Twyford Lane (7) DS0000015074.V346817.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 Twyford Lane (7) DS0000015074.V346817.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. Twyford Lane (7) DS0000015074.V346817.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Twyford Lane (7) Address 7 Twyford Lane Browns Wood Milton Keynes Bucks MK7 8DE 01908 639086 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) temadmin@birt.co.uk The Disabilities Trust Mrs Sandra Jane Stevens Care Home 3 Category(ies) of Physical disability (3) registration, with number of places Twyford Lane (7) DS0000015074.V346817.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13th November 2006 Brief Description of the Service: 7 Twyford Lane is a care home registered to provide rehabilitative care and accommodation for three younger people with an acquired brain injury. At present there are two residents one of which will move onto to a more independent unit shortly. The home is administrated by, The Brain Injuries Rehabilitation Trust, which is part of The Disabilities Trust. 7 Twyford Lane is situated on the Browns Wood development, which is to the south of the new town of Milton Keynes. The home is close to the local shopping districts of Old Farm Park and Walnut Tree and the more accessible and diverse Milton Keynes shopping centre. The home is close to a direct bus route that enables service users to have easy access to the towns of Bletchley and Milton Keynes as well as to main line train stations. The home is one of three properties built in a complex of small homes, all of which are administrated by The Brain Injuries Rehabilitation Trust. 7 Twyford Lane is a bungalow, which has been carefully adapted to provide for the needs of the service users who live there. Service users’ accommodation consists of single bedrooms with adjacent en-suite facilities. Communal areas consist of a lounge and kitchen/diner. The home shares a communal car park and garden with the other two properties on the complex. Fees range from £1899 to £2635 per week, according to information supplied by the manager in the pre-inspection questionnaire. Additional charges are made for personal items such as toiletries and outings. Twyford Lane (7) DS0000015074.V346817.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Commission has, since the 1st April 2006, developed the way it undertakes its inspection of care services. This inspection of the service was an unannounced “Key Inspection”. It was a thorough look at how well the service is doing. It took into account detailed information provided by the service’s manager, and any information that the CSCI has received about the service since the last inspection. Visit to the property Inspection of core documentation Consultation with service user, relatives and professionals associated with home. Discussion and feedback from staff Discussion with the registered manager Tour of the building and grounds Direct observation Analysis of submitted AQAA (Quality assurance tool) The inspection was due to be unannounced and take place on the 29th October. The inspector arrived to find that all staff and residents were out for the day. Due to the fact that there are only two residents and that part of the rehabilitation programme requires residents to be out and about the inspector phoned the manager to arrange a visit for the 31st October. The inspection took place on a weekday morning. One resident was on the premises at the time of the inspection. Core documentation was available for inspection and the inspector was able to have informal discussion with one resident. A tour of the building did not highlight any health and safety issues. On the day of the inspection the central heating system had stopped working this was quickly addressed prior to the end of the inspection and a contingency plan had been put in place should it have taken longer. The home provides good support to service users requiring rehabilitation with a view to moving onto greater independence. From the evidence seen by the inspector and comments received, the inspector considers that this service would be able to provide a service to meet the needs of individuals of various religious, racial or cultural needs. No complainant has contacted the Commission with information concerning a complaint made to the service since the last inspection. The inspector would like to thank the manager her staff and service users for their co-operation in this process. Twyford Lane (7) DS0000015074.V346817.R01.S.doc Version 5.2 Page 6 What the service does well: Thorough assessment is undertaken of prospective service users’ needs, to ensure that care needs are ascertained prior to providing a service. Needs arising from equality and diversity are well met, ensuring that the needs of each person’s individual situation are addressed. Care plans have been produced for all service users, ensuring that needs have been identified and can be met. Service users are enabled to make decisions and be as independent as possible, providing them with choice and involvement. Service users are enabled to take responsible risks, ensuring that their independence is promoted. Service users take part in appropriate activities and make use of the local facilities, providing stimulation and variety. Service users are enabled to keep in contact with friends and family, maintaining important social links. The rights of the individual are respected, promoting fulfilment and affording service users respect. Meals are appropriately managed to ensure that service users receive the nutrients they require to keep them healthy. Personal support needs are recorded in care plans to ensure that service users receive the assistance they require. Physical and emotional health care needs are well managed to ensure that service users keep well. Medication practice is safe and ensures that service users receive the medicines they require. Effective complaints procedures are in place to listen to the views of service users and their representatives. Adult protection is well managed with appropriate policies, procedures and staff training in place. Twyford Lane (7) DS0000015074.V346817.R01.S.doc Version 5.2 Page 7 A clean, comfortable and homely environment has been created for service users, ensuring that they have appropriate surroundings in which to live. Competent and qualified staff are working at the home thus ensuring that, service users are cared for by people who have the skills and knowledge necessary to meet their needs. Thorough recruitment practices are undertaken, to ensure that service users are protected from unscrupulous persons working with them. Training is undertaken by staff to ensure they are equipped to meet the needs of service users. The home s managed by a competent and qualified person, ensuring continuity of care and that needs are met. There is effective monitoring by the provider to ensure that standards of care meet the needs of service users. Health and safety is well managed overall, ensuring that staff, service users and visitors are not placed at risk of harm. What has improved since the last inspection? The local adult protection policy has been revised to state that both Social Services and the Commission for Social Care Inspection are to be notified of any adult protection concerns, allegations or incidents, ensuring that service users are adequately protected against the risk of harm. The home has modified its medication recording to ensure that where staff add a medication to the record sheet, initials or signature of the person adding the information has been added, and verified by a second person for accuracy. All staff in the home now ensure that the microwave is kept clean after use, and that it kept in a hygienic condition. A record of core food temperature checks is kept, to ensure that sufficient heat has prevented the growth of food poisoning bacteria. Twyford Lane (7) DS0000015074.V346817.R01.S.doc Version 5.2 Page 8 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. Twyford Lane (7) DS0000015074.V346817.R01.S.doc Version 5.2 Page 9 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 Twyford Lane (7) DS0000015074.V346817.R01.S.doc Version 5.2 Page 10 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, 2, 3, 4, 5 & 6. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Prospective service users are given sufficient information and are encouraged to visit the home to assess its suitability to meet their needs prior to admission. EVIDENCE: The home provides information about the home to prospective purchasers of the service. Information about the suitability of the service to meet the residents needs are usually made in a one to one situation giving residents time to gain a good understanding of what is on offer and available to them. The last resident to join the home transferred from another home within the organisation. The resident had several day visits to the home to assess suitability on both sides. There are two service users in the home at the present time one male one female Two resident’s files were viewed and evidenced that residents are being consulted and informed where possible about changes and challenges available to them. Both residents of the home have a good range of recreational and leisure activities. Twyford Lane (7) DS0000015074.V346817.R01.S.doc Version 5.2 Page 11 New residents are encouraged to visit the home prior to making a final decision as to the suitability of the home. This also enables the home to assess its suitability to meet the residents care needs. Regular reviews take place to ensure that this is still the case. Service users have individual written contracts and terms and conditions. Relatives or advocates are involved in the contracting process to assist the individual resident to be safeguarded. Twyford Lane (7) DS0000015074.V346817.R01.S.doc Version 5.2 Page 12 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): 7, 8, 9 & 10. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents are consulted regularly to ensure that the home is meeting their needs and choices. EVIDENCE: Two service users care plan and associated documentation were seen. They included comprehensive information about personal care routines, how much support individuals need, and how to give it. Both residents in the home are able to partake in the care plan and have a say about the information held on them. Both residents have problems associated with Brain Injury following a Road Traffic Accident. The aim of the home is to equip them with the skills and confidence to move onto a more independent life. This process is unhurried and takes into account the wishes and needs of the service users. Individual Lifestyle support plans include a short life history, what is vital for staff to know, likes and dislikes, achievements, level of support required, the best way to get to know me, what I like and don’t like and “what worries me Twyford Lane (7) DS0000015074.V346817.R01.S.doc Version 5.2 Page 13 “are all included in the residents file. The future needs are noted on reviews which service users are supported and encouraged to attend. Families also are invited to attend reviews and sign the review notes. Service users’ care plans are very detailed and include all the necessary information to ensure that staff can meet their individual personal support needs. There is a description on individual files of the service user’s ability/limitations with regard to decision- making and how to ensure that they are given appropriate choices, such as sampling different activities before being asked what they want their daytime activities programme to consist of. Regular one to one meetings are held at which various subjects are discussed, including activities for the week, the rotas, complaints, health and safety and any other issues arising. These meetings are recorded and were seen to be appropriate at this inspection. Staff employed a variety of activities to keep service users interested and occupied. The home has procedures in place to deal with a missing resident. Photographs are available. Service users have identification and mobile phones. Resident’s are accompanied by a member of staff outside the home this is only until such time as it is felt that they are safe and comfortable to go out for short periods of time. The home has appropriate policy and procedure to handle service users finances if they are required to do so Any specialist communication need is identified and recorded on file. Staff are informed of these needs and any areas of training are identified. Residents are encouraged to have contact with family and friends Confidential information is kept confidential. Risk assessments were seen were detailed and reviewed. Twyford Lane (7) DS0000015074.V346817.R01.S.doc Version 5.2 Page 14 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): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The whole ethos of the home is to encourage service users to have as full a life as they are able and to move onto a more independent selfsufficient lifestyle. EVIDENCE: The management and staffing of the home is geared up to service users being out and about and a full programme of activities both in the home and in the community is available. Part of the independence training revolves around shopping, preparing meals and laundry. The use of public transport and handling money also form part of the independence training. The local community is used as a safe environment for service users to practice their new- found skills prior to going into the wider community. Steps are taken to ensure safety whilst at the same time enabling service users to take acceptable risks. Twyford Lane (7) DS0000015074.V346817.R01.S.doc Version 5.2 Page 15 Regular trips are also planned to met the social and emotional needs of service users and include holidays, cinema, pubs restaurants and socialising with friends relatives and other service users from different homes. Food is kept individually in a cupboard, and each service user has their own space in the fridge. Drinks and fresh fruit are always available. As part of the independence training service users are encouraged and assisted to prepare their own breakfast and lunch. The evening meal is a communal meal with staff assisting service users to cook on a rota basis. Diet is monitored and healthy eating is encouraged. Regular weight checks are recorded and where weight is felt to be a problem, fitness programmes are looked at. One resident is being encouraged to attend the local gym. Evidence was found at the inspection that service users have regular contact with their family and friends. Visitors are made welcome to the house. Twyford Lane (7) DS0000015074.V346817.R01.S.doc Version 5.2 Page 16 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 & 21 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents are encouraged to maintain a healthy lifestyle and have access to a range of healthcare services. EVIDENCE: Evidence was found at the inspection that steps had been taken to involve service users in decisions about their care plan and the manner they would like care to be given. Preferences for getting up and going to bed are taken into consideration, as is time for service users to be alone. The current resident’ s require minimum assistance with personal care and apart from wheelchair accessibility no specialist equipment is required in the home. Evidence was found on file that service users are attending regular appointments to see both main- stream health services and where required specialists. A holistic approach is take to residents health additional services such as speech and language therapy and physiotherapists are accessed as and when required. Twyford Lane (7) DS0000015074.V346817.R01.S.doc Version 5.2 Page 17 Residents are encouraged to take an active part in the management of their medication. Assistance is available for those who wish it. Medication was checked and the inspector found a robust system in place to ensure the safe administration of medication. No errors were found in either the recording or storage of medicines. Medication was kept in a locked cabinet and clear records were being kept. Twyford Lane (7) DS0000015074.V346817.R01.S.doc Version 5.2 Page 18 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Service users are consulted as to the quality of the service being provided and are able to make comment both positive and negative. EVIDENCE: The home uses the organisations formal policy on making a complaint. Due to the small size and nature of the home, redress to formal process is very rarely used as each service users has a key worker who has regular one to one sessions. These sessions enable concerns or complaints and changes to the daily routine to be discussed prior to reaching a complaints stage. Therefore no formal complaints have been logged since the last inspection. No complainant has contacted the Commission with information concerning a complaint made to the service since the last inspection. Evidence was found that the home has appropriate adult protection procedures in place and all staff working in the home have attended training in the Protection of Vulnerable Adults. Following a requirement from the last inspection report policy has been amended and now meets the requirement. Twyford Lane (7) DS0000015074.V346817.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 is good This judgement has been made using available evidence including a visit to this service. The home is well maintained and provides a homely and safe environment for its residents. EVIDENCE: 7 Twyford Lane is situated on the Browns Wood development, which is to the south of the new town of Milton Keynes. The home is close to the local shopping districts of Old Farm Park and Walnut Tree and the more accessible and diverse Milton Keynes shopping centre. The home is close to a direct bus route that enables service users to have easy access to the towns of Bletchley and Milton Keynes as well as to main line train stations. The home is a bungalow, which has been carefully adapted to provide for the needs of the service users who live there. Service users’ accommodation consists of single bedrooms with adjacent en-suite facilities. The manager confirmed that new residents would be consulted as to the décor and colour of their room and enabled to make it as personal as they wished. Communal Twyford Lane (7) DS0000015074.V346817.R01.S.doc Version 5.2 Page 20 areas consist of a lounge and kitchen/diner. The home shares a communal car park and garden with the other two properties on the complex. A recommendation was made at the last inspection that the microwave be cleaned a regular basis this is now on a rota as part of the overall cleaning schedule. The home has plans to completely redecorate the house over a period if time. New shower trays and flooring will be added. Room 3 will have a complete redecoration and the current adaptations to this room will be removed. The home also plans to replace crockery and cutlery. On the day of the inspection the central heating had stopped working a contingency plan of heating had been put in place pending permanent repair. The maintenance company arrived during the inspection and fixed the heating. The home is to be commended for the way in which this situation was dealt with. Twyford Lane (7) DS0000015074.V346817.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. Staff rota’s evidenced that the home provides sufficient staff to meet the needs of its service users. EVIDENCE: As previously mentioned this inspection should have been unannounced but due to the nature of the home in that service users are often out and about. The inspector decided to make the inspection a short notice inspection. On arrival the homes Manager and Area Manager were on duty in the home. One resident was present during some of the inspection but had activities planned for that day. A second member of staff was out with the second resident and would not be back till the evening. Much of the homes work involves one to one work away from the home. Staff rota’s were structured in such a way as to meet this flexible need. The home has one member of staff sleeping in as a safety precaution ensuring that if there are problems during the night they can be quickly dealt with. Where staff cover is required for sickness or annual leave. Staff known to the service users, are brought in to provide consistency of care. Twyford Lane (7) DS0000015074.V346817.R01.S.doc Version 5.2 Page 22 Staff training was being given a high priority with all staff having a training programme. The company trainer has recently been recruited and will take up the training programme. All staff files were inspected and found to contain the information required under this regulation. Evidence was found, that staff are being recruited in an equal opportunities framework and that references and police checks are taken up. The company provides its staff with a formal induction prior to working on their own. Regular support and supervision is available both formal and informal. Formal supervisions sessions are recorded. The company ensures that, staff are inducted in the companies policy on disciplinary and grievance procedures and are asked to sign a confidentiality agreement. The staff team is small, reflective of the size and nature of the service. Staff meetings take place regularly and issues affecting the home are discussed and moved forward. There is frequent support from the registered manager, who is based off site but visits regularly, plus the clinical psychologist was working closely with the staff team. Twyford Lane (7) DS0000015074.V346817.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, 39, 40, 41, 42 & 43. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The home has the support of a large parent organisation and as such is professionally managed and accountable. EVIDENCE: The home has a house leader, who has just returned from maternity leave and is charge of day- to- day running of the service. The community support manager is registered as manager and she has undertaken National Vocational Qualification level 4 Registered Manager’s Award and has the necessary experience and skills to ensure that the service operates to a high quality and that service users receive the support and assistance they require. Efforts are made to ensure that residents have as much say in how the home is run as is possible. Time is spent with residents reviewing the current home Twyford Lane (7) DS0000015074.V346817.R01.S.doc Version 5.2 Page 24 systems a care plans and the outcomes of these sessions are inputted into the running of the home. The home implements the parent companies policies and procedures on health and safety and adapts them to suit the particular situation of the home. All records inspected were up to date and well recorded. The management of the home has been consistent during the house leaders absence. Reports of monthly monitoring visits by the provider have been forwarded to the Commission on a regular basis and provide good evidence of detailed monitoring. Copies were also available in the office at the home. Health and safety is well managed with a range of checks in place. There was a current gas safety certificate in place, testing of portable electrical appliances had been carried out. The home has domestic smoke and heat detectors in place, which are tested regularly for efficiency. Extinguishers had been serviced and regular drills had been undertaken to ensure that safe evacuation procedures are rehearsed. A daily register is kept and the means of escape are checked regularly. Accidents and incidents are appropriately recorded and any serious matters reported to relevant agencies, such as the police. Checks are made of fridge and freezer temperatures and hot water temperatures and shower heads are cleaned regularly to prevent build up of lime-scale and bacteria. Core temperatures of cooked foods are also checked but not recorded by staff or service users. It is recommended that a record be established to ensure that sufficient internal heat is achieved to prevent the growth of food poisoning bacteria. Twyford Lane (7) DS0000015074.V346817.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 3 4 3 5 3 3 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 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 3 3 3 3 3 3 3 Twyford Lane (7) DS0000015074.V346817.R01.S.doc Version 5.2 Page 26 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. 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 Twyford Lane (7) DS0000015074.V346817.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Oxford Area Office Burgner House 4630 Kingsgate, Cascade Way 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 Twyford Lane (7) DS0000015074.V346817.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!