Inspection on 25/07/07 for Wade House

This inspection was carried out on 25th July 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

Wade House 18/08/06

Wade House 04/01/06

Wade House 07/02/05

Wade House 11/08/04

Wade House 26/02/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Wade House Wade House Violet Hill Road Stowmarket Suffolk IP14 1NH Lead Inspector John Goodship Unannounced Inspection 25th July 2007 09:00 X10015.doc Version 1.40 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 Wade House DS0000037227.V347153.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 Older People. 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. Wade House DS0000037227.V347153.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Wade House Address Wade House Violet Hill Road Stowmarket Suffolk IP14 1NH 01449 626250 01449 626251 karen.curle@socserv.suffolkcc.gov.uk 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) Suffolk County Council Ms Karen Curle Care Home 30 Category(ies) of Dementia - over 65 years of age (8), Old age, registration, with number not falling within any other category (22) of places Wade House DS0000037227.V347153.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th August 2006 Brief Description of the Service: Wade House is a Residential Care Home providing personal care and accommodation to 30 older people. It is registered to provide care for eight people with dementia and twenty-two older people over the age of sixty -five. The home is owned and managed by Suffolk County Council. It is situated in the town of Stowmarket in a residential area with shops and other local amenities nearby. The home is purpose-built on two floors, which are accessed by stairs or by passenger lift. Externally there are two garden areas and a two parking areas. One garden is directly accessible to service users accommodated within the dementia care unit. All bedrooms are single occupancy with no en-suite facilities; seven bedrooms have under 10 square metres usable floor space. At the time of the inspection the fees charged were in the range £293.00 to £397.00 per week. Wade House DS0000037227.V347153.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection visit was unannounced and covered the key standards which are listed under each outcome group overleaf. This report includes evidence gathered during the visit together with information already held by the Commission. The inspection took place on a weekday and lasted six and a half hours. The manager was present throughout, together with staff on the morning and the late shift. The inspector toured the home, and spoke to some of the residents, staff, and visitors. The inspector also examined care plans, staff records, maintenance records and medication records. A questionnaire survey was sent out by the Commission to residents, relatives and staff. Thirteen residents responded, eighteen relatives, and four staff. Their answers to the questions and any additional comments have been included in the appropriate sections of this report. The manager was also required to complete a pre-inspection questionnaire, which provided information which has been included in the report. What the service does well: The home is good at providing information to residents and relatives by display units and noticeboards in the entrance. There is a thorough pre-assessment process, with opportunities for prospective residents to have “look/see” visits. The staff try to gather as much information as possible about the person and their life story before admission so that they can arrange appropriate care. The home surveys residents for their views regularly and responds to their comments and concerns. Residents and visitors comment on the friendliness and willingness of the staff. “My relative really feels at home because they make it so lovely and friendly.” Another relative wrote: “My relative would not be here today but for the care and attention they have received from the caring staff.” A resident wrote: “ My visitors were so surprised to think that there’s such a clean and friendly place around.” Many residents praised the staff and their prompt attention to their needs. Wade House DS0000037227.V347153.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Wade House DS0000037227.V347153.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Wade House DS0000037227.V347153.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4,5. Standard 6 is not applicable. Quality in this outcome area is good. Prospective residents can be assured that they will have sufficient information to decide if this home is where they wish to live. The home will also collect information to assure the person that the home can meet their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Statement of Purpose had been revised in May 2007. This had been prepared in case the home needed to seek a variation for a current resident who had developed dementia. However the manager had been informed that a variation in such an instance was no longer required. Wade House DS0000037227.V347153.R01.S.doc Version 5.2 Page 9 The Service User’s Guide had also been revised and included information on the keyworker system. A register was kept to confirm that new residents had received a copy. This had been a requirement at the last inspection visit. The Guide was produced in large print and was seen in several resident’s rooms. Copies of the Guide and the Statement of Purpose were also displayed on a table in the hall, together with the latest CSCI inspection report, and information leaflets about rights and benefits. When there was a vacancy, the notification of the vacancy went to the Care Home Placement Team who kept a database of the demand for places. They forwarded names to social workers and the process for admission to the home started. A new resident had been admitted some days previously from hospital. The records showed that there was the Compass assessment from the social workers, and a pre-admission assessment by the manager, who had visited the person in hospital. A visit had been arranged and the person had decided to stay. The home was now closely assessing the person’s needs to determine whether the home was the appropriate placement because of their moving and handling needs. A previous resident had developed needs which the home could not meet. After consultation and assessment by the home and external professionals, the person was transferred to a care home with nursing. A resident wrote in their survey form that they had come to the home for respite care after a hospital stay before moving in permanently, “so I did know what it was like”. A relative said they had visited the home to assess its suitability for their relative and were well pleased with what they saw. Another relative said that they received a very warm welcome from staff when their relative was admitted, and received important information about their needs and care. All places were full on the day of inspection although three residents were receiving treatment in hospital. These admissions had been correctly notified to the Commission. The home accepted people for short-term care. The inspector spoke to a visitor of a short-term care resident. They and their relative were very impressed with the home. The room was very comfortable with good food and friendly staff. Wade House DS0000037227.V347153.R01.S.doc Version 5.2 Page 10 Wade House DS0000037227.V347153.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 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. Residents can be assured that their health, personal and social care needs are set out in an individual care plan. Needs are assessed and reviewed regularly to ensure that residents are properly cared for. Medication procedures ensure that residents are safe. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Three care plans were examined. All were organised on a similar pattern. All files included the pre-admission assessment. This was very thorough and compiled mainly during the pre-admission meeting with the prospective resident and their relatives, thus enabling a full picture of the person and their needs to be compiled. There was evidence of regular monthly reviews, including separate night care reviews. Longer-term reviews were held, some with relatives, social workers and medical staff as appropriate. It was noted Wade House DS0000037227.V347153.R01.S.doc Version 5.2 Page 12 that decisions at a review affecting the care tasks had been transferred onto the care plan for staff to follow. Risk assessments included those for pressure area care, continence and the use of bedrails, and moving and handling. The relative of one resident with dementia was concerned that the person needed support when eating a meal and was very slow. The inspector observed this during lunchtime. The staff offered encouragement and support. The last care plan review in January 2007 identified that the resident needed support and was slow. There had been concern that they had been losing weight. The home used the MUST Nutrition Tool for assessing progress with weight and nutrition. Weight records for this person, which had been taken fortnightly for a period, showed that their weight had now stabilised. They were now weighed monthly, as were all other residents. The home had a weighing chair which allowed all residents to be weighed even if they could not weight-bear. NHS professionals were involved as appropriate and their visits were recorded. The MUST tool had triggered referrals to the dietitian and speech therapist for particular residents. One resident had been assessed as needing nursing care and had now been moved to a care home with nursing. Before that happened, the home had allocated extra care time for their needs, including regular turning (on a special mattress supplied by the district nurse). Instructions for this were in the care plan. The drug policy had been revised and updated in April 2007. It now included reference to the system for the receipt of tablets in packaging issued when residents were discharged from hospital. Team Leaders were the only staff trained to administer medication. Their training had been done in-house augmented by a workbook programme from a social care learning service. Other staff received an appreciation of medication practice through the Common Induction Standards training when they joined the home. The lunchtime medication round was observed. All tablets were correctly accounted for from delivery to the day of inspection. The staff member was seen to pot up the tablets, take them to the resident and confirm that they were taken, before signing the Record Sheet. No signing gaps were seen from a sample of Record Sheets. The special needs unit, Willow, had eight places. The staff on duty were able to describe the residents’ needs fully. They were seen to be interacting with them in a friendly and encouraging way. There were photos of each person on their bedroom door. One resident was a smoker. There was a risk assessment for this activity which enabled them to smoke in designated areas. There was a storeroom for the activities materials. The team leader reported that the favourite activities were bingo and cake making. There was access to the Wade House DS0000037227.V347153.R01.S.doc Version 5.2 Page 13 garden from Willow. Staff said the garden was used occasionally. It was secure and there were no restrictions on those living on Willow either to go in the garden or to visit other parts of Wade House. However because of the security systems, staff would always be aware when a resident had left the unit. Wade House DS0000037227.V347153.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15. Quality in this outcome area is adequate. Residents cannot yet be assured that they will be offered a sufficient range of activities to meet their own needs and interests. Residents can be assured that they will be provided with nutritious and well-presented food which they help to choose, and they will monitored to ensure they remain properly fed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Several residents and relatives said that there should be more activities, and outings. “The only time I go out is when my family take me.” “There should be provision of more activity within the home.” The part-time activities organiser had been on long-term sick leave for over a year. All activities had to be paid for from the amenity fund, eg materials. There was no separate budget for this. The provider paid the salary of the activities organiser. The manager explained that staff were continuing to provide a varied programme. The staff who came on duty for supper cover would arrange Wade House DS0000037227.V347153.R01.S.doc Version 5.2 Page 15 activities such as cards and dominoes. Other activities advertised on the notice board were bingo, a sing-along and darts. Since June, one of the team leaders had taken on overall responsibility for activities and was hoping to offer more creative and stimulating choices. In order to provide a trip outside the home, the manager explained that the home would need to hire a wheelchair accessible minibus, and ask for volunteers from the staff, as there was no budget allowed for hire or staff costs. It was noted that staff on Willow spent time talking to residents and going through the paper with them. A hairdresser visited twice a week. She was present on the day of inspection. The home had converted the end of a communal lounge into a well-fitted salon. All the residents who replied to the survey said they always or usually liked the meals. One said: “I do enjoy the food here. I don’t like fish on Friday so I am given a choice of something else. It’s no problem.” The main course for lunch on the day of inspection was sausage pie, with potatoes and vegetables. Residents were able to have more if they wished. One resident told a carer they thought the sausage was too salty. The carer went to the kitchen to check with the cook. She said that that no further salt had been added to the sausage meat which was delivered from the supplier. There was banana custard for dessert. Breakfast was available from 08:00 to 10:30 and a range of food both hot and cold was always available. Wade House DS0000037227.V347153.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18. Quality in this outcome area is good. Residents and relatives can be assured that their concerns will be listened to, and that they will be protected from abuse by the home’s training for staff. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home had a complaints procedure called “Having your say”. This was advertised in the hall as well as detailed in the Service Users’ Guide. The home had recorded eight complaints in the previous twelve months. These had been recorded in the complaints log with dates when they were responded to. Two of the issues had been raised by staff, concerning a practice matter and a delay in responding to the emergency bell. Two other issues had been reported by the manager to the local authority under the Adult Safeguarding procedure because of action taken by individuals not employed by the home. The manager was an Adult Protection trainer, and organised in-house training in the protection of vulnerable adults. Staff also received training on their Common Induction Standards (CIS) training and on NVQ courses. The manager was also putting all staff through the CIS module “Recognise and respond to abuse and neglect” as a means of refreshing their knowledge. She Wade House DS0000037227.V347153.R01.S.doc Version 5.2 Page 17 was able to show the inspector the staff’s question papers which she was in the process of marking. A member of the care staff who spoke to the inspector was able to describe types of abuse, and what action they would take on witnessing any such. Recruitment checks on staff’s identities and histories further protected residents. Wade House DS0000037227.V347153.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,24,25,26. Quality in this outcome area is adequate. Residents and relatives can be assured that the home provides a comfortable and well-maintained environment and that they are able to personalise their rooms should they wish to do so. They cannot yet be assured that their safety is fully protected until fire protection has been upgraded. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The hall provided a large space for residents and visitors to access the various parts of the home. It contained information for residents, relatives and staff on the CSCI and its reports, on accessing welfare benefits, on what was happening in the home. Because of the review of residential care being undertaken by the County Council, information about this process was displayed. There was also a list of resident and staff meeting dates and minutes. Information on staff training opportunities was displayed. Wade House DS0000037227.V347153.R01.S.doc Version 5.2 Page 19 The planned changes to the front conservatory to prevent visitors walking through a smoking area had not been able to be funded. So smoking was now not now allowed in this area. The only person who smoked was a resident of Willow who went into Willow’s garden with staff surveillance to smoke. A glass panel at the head of the main staircase had not yet been replaced with the type of glass required by the Fire Officer in November 2006. Because of the security protection for Willow residents, other residents could only access this garden with staff help. This garden was well provided with benches and a covered sitting area. There was another garden in the centre of the building but it was not accessible to residents. There were no seats or other facilities there. The rooms of residents were clean and held personal items of decoration and mementoes. All doors to rooms were fitted with self-closing devices which could be held open at any angle. The Fire Officer had inspected in November 2006. A requirement was made to fit toughened wired glass to a panel in the stairwell. This had not yet been done. The reminiscence room on the first floor had been changed into a staff training room. The manager advised that it had not been much used because of its location. She had so far been unable to find an alternative location on the ground floor. The home was clean and there were no unpleasant odours. The COSHH cupboard containing hazardous substances was locked. There were disinfectant gel dispensers on the walls to back up hand washing in preventing cross infection. Wade House DS0000037227.V347153.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30. Quality in this outcome area is good. Residents are cared for by well-trained staff, whose care and concern is appreciated by residents and relatives. Residents can expect that they will be protected by the home’s thorough recruitment procedures. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The daytime staffing levels were two carers plus a senior on Willow, and three carers and a senior for the rest of the home. There was one vacancy for a parttime carer for seven nights a month. The use of agency staff had reduced considerably over the last year, with only five shifts being covered by agency staff in the last three months. There was some stability amongst the staff with only two new staff in the last twelve months. There had been difficulty in recruiting domestic staff. Although vacancies were now filled, the manager had booked the Council’s in-house team, Suffolk Caretakers, to come and do a complete clean to bring the home up to standard. There had been some lack of clarity about responsibility for some tasks among domestic staff. This had now been sorted out. Domestic staff cover was provided from 08:00 hours to 20:00 hours during the week, with shorter hours at weekends. Wade House DS0000037227.V347153.R01.S.doc Version 5.2 Page 21 One relative commented that there did not seem to be enough staff on duty at times. The manager said that Willow had three staff for eight residents. However, supporting the other twenty two people across two floors stretched staff at times, but the introduction of an extra carer over the breakfast time had helped during the time when residents needed most support. One resident put in their survey that “carers come as soon as I ring the bell. They may ask if it’s an emergency if they are helping another person”. The Workforce Planning Sheet listed the NVQ qualifications of each person, with the numbers in training in the current year, and the number to be trained next year. The home exceeded the recommended level of 50 of care staff with NVQ Level 2 or above. Indeed, apart from the manager, three senior staff had Level 4 and ten staff had Level 3. New staff followed the Common Induction Standards programme through the Council’s training section. In-house refresher training took place using Skills For Care standard modular workbooks, covering POVA, medication, supervision skills, and in-house budget training. Staff had attended the Unisafe 1 and 2 programmes for handling challenging behaviour. Staff had received a three day course on caring for people with dementia. But some of this had taken place some time ago. One staff member said it was three years ago for them. The manager said they were changing to the SCILS Match workbook on dementia care which all staff would complete. As the inspector arrived, a team leader and the handyman were off to an information session on Legionella to be updated on new procedures as part of the County Council’s cross-infection policy. The recruitment records for two staff were examined. Both contained the identification, references and CRB documentation required. Training records were also included. A member of staff confirmed that they had received sufficient training to do their job, and that they had regular supervision sessions. They were able to describe the action they would take if they witnessed an incident of abuse. A relative described staff as professional and caring. “The manager and staff alike treat residents with respect.” Wade House DS0000037227.V347153.R01.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35,36,38. Quality in this outcome area is good. Residents and relatives can expect the home to be well run, by competent staff. Their safety is assured by the home’s health and safety practices. Residents can be assured that there is a system for obtaining their views on the running of the home to ensure it is run in their best interests. A process of staff supervision protects residents by continually monitoring and improving the skills of the staff. This judgement has been made using available evidence including a visit to this service. Wade House DS0000037227.V347153.R01.S.doc Version 5.2 Page 23 EVIDENCE: The manager had been at Wade House since May 2003 and became the registered manager in November 2005. She was qualified at NVQ Level 4 and had attended a course in dementia care mapping. Staff meetings were held monthly. The minutes were seen in the hall. However the manager stated that no member of staff attended the recent planned meeting. Residents’ meetings were held four times a year but the manager said that residents preferred to speak to her on a one-to-one basis. The dates of these meetings were displayed in the hall. The fire log was inspected. It was up-to-date with fire drills recorded, including the names of staff on duty, emergency lighting checks, weekly alarm system tests, and monthly extinguisher checks. There had been fire training sessions on the 17th and 18th of July 2007. The Fire Risk Assessment had been amended on 2 July 2007 with staff signing that they had read it. The lack of action on the Fire Officer’s requirement has already been detailed under Environment. Following a problem with Legionella at one of the provider’s other premises, new checks had been put in place with risk assessments. These were the subject of a training session on the day of inspection attended by the maintenance man and a team leader designated as health and safety officer. The hot water tank temperature would now be checked monthly, and showerheads would be cleaned and descaled monthly. The temperature of hot water outlets was already tested on a monthly schedule. The manager advised that the home’s emergency plan was being revised that month, covering plans for fires, gas leaks, floods, bad weather, power cuts and infectious diseases outbreaks. Work done so far was shown to the inspector. Construction work on an adjacent site required the power to be cut off for a short time in the afternoon of the inspection. Staff had plenty of warning, and residents and visitors were aware of the cut. The most obvious result of the cut was the closing of all fire doors. No detriment to any resident was observed. The Department of Health advice on safe clean care “Essential Steps” had been used to inform policies and the emergency plan. The system of monthly visit reports by other managers, part of the provider’s quality assurance process, was about to be changed. Instead of managers of other homes visiting, a senior manager would cover all the provider’s homes for older people. It has already been reported that a survey of residents in May 2007 had resulted in the shifting of the supper time to give more time for activities in the afternoon, with residents being offered tea and cakes during the afternoon. Wade House DS0000037227.V347153.R01.S.doc Version 5.2 Page 24 The home did not handle money on behalf of residents. The Statement of Purpose and Service Users Guide confirmed this. All financial procedures and payments were handled by the County Council’s finance department. Lockable cabinets were available in bedrooms for residents to keep valuables securely. The record of supervision sessions for staff was up-to-date with sessions six times a year. There was also an annual Performance Development Review for all staff. Wade House DS0000037227.V347153.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 Older People 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 3 X X X 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 3 3 X 2 Wade House DS0000037227.V347153.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. 1. Standard OP38 OP19 Regulation 23(4) Requirement The requirement of the Fire Officer to replace the glass panel at the head of the main staircase must be implemented. Timescale for action 30/09/07 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 OP12 Good Practice Recommendations The development of a wider range of activities geared to the wishes of the residents should be planned and monitored. The access to, and use of, the garden areas should be reviewed for the enjoyment and convenience of all residents. 2. OP19 Wade House DS0000037227.V347153.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Suffolk Area Office St Vincent House Cutler Street Ipswich Suffolk IP1 1UQ 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 Wade House DS0000037227.V347153.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. 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