Inspection on 10/12/07 for Walton House

This inspection was carried out on 10th December 2007.

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

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Walton House 17/10/06

Walton House 15/02/06

Walton House 11/11/04

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

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

CARE HOME ADULTS 18-65 Walton House 4 Walton Crescent Lanesfield Wolverhampton West Midlands WV4 6DX Lead Inspector Rebecca Harrison Key Unannounced Inspection 10th December 2007 12:40 Walton House DS0000030209.V351239.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 Walton House DS0000030209.V351239.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. Walton House DS0000030209.V351239.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Walton House Address 4 Walton Crescent Lanesfield Wolverhampton West Midlands WV4 6DX 01902 563223 01902 683320 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) Arcare (West Midlands) Ltd Mrs Suman Bala Sharma Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Walton House DS0000030209.V351239.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: No conditions apply Date of last inspection 17th October 2006 Brief Description of the Service: Walton House is registered with the Commission for Social Care Inspection (CSCI) to provide accommodation and care for a maximum of three adults with a learning disability. The registered provider is Arcare (West Midlands) Limited. Mr Raj Kishan Sharma is the responsible individual and Mrs Suman Bala Sharma the registered manager. The property is a traditional style semi-detached property, which is located in a residential area of Lanesfield approximately 3 miles from Wolverhampton City Centre. The home offers access to local amenities and transport and is in keeping with the local community. Accommodation is provided over two floors providing single bedrooms, a lounge, dining room and kitchen. A small garden is provided at the rear of the property. The homes philosophy is to Maintain a high standard of care, respecting individuality, privacy, residents dignity and independence at all times. First and foremost a happy and secure environment within the home. People who use the service and their representatives are able to gain information about this service from the Statement of Purpose and Service User Guide. Inspection reports produced by CSCI can be obtained direct from the provider or are available on our website at www.csci.org.uk The range of fees charged range from £412.00 - £480.00 per person per week. This information should be included in the Service User Guide as required; therefore the reader may wish to obtain this information direct from the service provider. Walton House DS0000030209.V351239.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The provider was given one hours notice of this inspection to enable access to the home as the service is not staffed at all times. The inspection took place on 10th December 2007 by one inspector over five hours. A range of evidence was used to make judgements about this service to include a tour of the home, discussions with all service users, staff on duty, the area manager and a relative. The inspector also looked at a number of records and observed aspects of care provided for two people using the service. In preparation for the inspection we received nine surveys from people using the service, relatives, staff and health professionals and some of their comments have been included in this report. The registered manager was on leave at the time of the inspection however the former deputy manager and area manager assisted in the inspection process. Prior to this inspection an Annual Quality Assurance Assessment (AQAA) document was posted to Walton House for completion. The AQAA is a selfassessment and a dataset that is filled in once a year by all providers. It informs us about how providers are meeting outcomes for people using their service and is an opportunity for them to share with us areas that they believe they are doing well. By law they must complete this and return it to us within a given timescale, which they did and some of their comments are included within this inspection report. The purpose of the inspection was to assess all ‘Key’ National Minimum Standards for Younger Adults and to review the 3 requirements made as a result of the previous key inspection undertaken in October 2006. A quality rating is provided throughout the report based on each outcome area for the people who use the service. These ratings are described as excellent/good/adequate or poor based on findings of the inspection. What the service does well: Staff continue to be provided with excellent training opportunities and have attended training in safe working practices and training specific to the needs of the people they support. People’s healthcare needs are well monitored and referrals made to the appropriate health and social care professionals as required. Some of the comments that we received include: ‘I like living here, the staff are nice’. ‘I am very pleased with the care my brother is getting, the staff are very friendly’ Walton House DS0000030209.V351239.R01.S.doc Version 5.2 Page 6 ‘Excellent training opportunities, good support and guidance, good record keeping systems, good medication procedures, good service user health care needs’. ‘We treat the residents very well and also respond to their every need as best we can’. ‘Not a lot’ ‘They have responded well to communication advice I have given’ ‘We look after the people very well and listen to their complaints’ What has improved since the last inspection? What they could do better: As identified through previous inspection reports the home requires investment to provide people with a more homely place to live. Quality assurance systems require further development to assess performance and evaluate outcomes for people using the service. Discussions held with service users and observations made indicate that people could be provided with greater opportunities to develop their independence for example, by helping prepare their own meals, cleaning etc based on a risk assessment. More structured and meaningful activities could be introduced. The area manager intends to streamline the homes record keeping systems in order to make records more are easily accessible to staff. Medication procedures need to be improved. All staff must adhere to the presribers directions unless instructed by the General Practitioner to ensure peoples health needs are met. Walton House DS0000030209.V351239.R01.S.doc Version 5.2 Page 7 Staff should develop a greater understanding of empowering the people they support. Some of the comments that we received include: ‘Give staff more money for a job well done’ ‘More staffing per shift’ In my opinion the food any many other things could be made better for the service users’. ‘We need a handyman who can do all the jobs that need doing. Staff views need to be taken into account when service user needs are to identified’. 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. Walton House DS0000030209.V351239.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 Walton House DS0000030209.V351239.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): 1,2, 4 and 5 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. People are provided with the information needed to decide whether this service will meet their assessed needs. They are given the opportunity to visit the home and are provided with a contract, which tells them about the service they will receive. EVIDENCE: The home has a Statement of Purpose available. The document requires updating to reflect the new organisational structure, management and staff qualifications. People have access to a Service User Guide and the area manager committed to updating the guide to comply with the changes in the Care Home Regulations as amended in September 2006. Since the last inspection one person has been discharged as the home were unable to meet the persons declining physical health needs. One person has been admitted to the home following an assessment of his needs undertaken by the placing authority. It was reported that managers visited the person in his former placement however no completed record of formal assessment undertaken by the provider was available on file. The area manager reported that this would be addressed for all future admissions to the service. Walton House DS0000030209.V351239.R01.S.doc Version 5.2 Page 10 Discussions held with the new service user indicate that he visited the home prior to admission to meet existing service users and staff and the outcome of the visits were seen recorded on his file. Observations made evidence that the person has settled into the home well and has developed positive relationships with his peers and staff. Discussions held with him indicate that the placing authority is currently sourcing alternative accommodation in a supported living service in order to develop his independence as requested. A signed copy of his contract was available outlining the service agreed. Walton House DS0000030209.V351239.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): Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Staff are not provided with sufficient information to ensure they are able to meet all peoples individual needs, aspirations or to enable them to achieve their personal goals. People are supported to make decisions about their lives and enabled to take some responsible risks however identified risks must be assessed and regularly reviewed to ensure people are fully safeguarded. EVIDENCE: All records held on behalf of the person most recently admitted to the home were examined in addition to one existing person. A needs assessment had been obtained by the placing authority and a very brief support plan completed by the provider was available however the area manager fully acknowledged that the plan provided staff with minimal information and had not been generated from the initial assessment failing to cover all aspects of personal, social support and healthcare needs for staff to offer appropriate support. Walton House DS0000030209.V351239.R01.S.doc Version 5.2 Page 12 Records indicate that a formal review had recently been held with the service user and significant others and a report available. A support plan and assessment of risk was available on the file of the other person case tracked with evidence of formal review and a comment from the placing authority stating ‘Attended a review, documents in order, action has been taken and home is meeting his care needs’. It was reported that a healthcare professional is currently developing a person centred plan for one individual and that all staff have received awareness training in person centred planning and are hoping to access facilitators training shortly. A review for the third person living at the home has been scheduled as confirmed by the individual and the records held on file. The self assessment completed by the provider states ‘The home strives to empower service users care by valuing diversity, making advocacy available, actively listening to build a supportive relationship, offering choices and using person centred approaches’. One person has regular contact with an independent advocate and he was happy to share some of the work undertaken with the inspector, which is proving positive. The other two people have regular contact with relatives who help advocate in the best interests of service users. A number of surveys that we received suggest that individuals could be better supported with decision making and offered more choice. Discussions held with the area manager indicate that she has started to address this in relation to meals, food and the environment. Assessments to support a service user to take responsible risks were available on one of the files examined but not on the other which potentially places the individual at risk and does not provide staff with the relevant information to effectively support the individual. The area manager committed to ensuring this is dealt with as a matter of urgency in conjunction with relevant parties. Walton House DS0000030209.V351239.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): 12,13,14,15,16 and 17 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. People who use the service are provided with some educational and social activity and are supported to keep in contact with their family and friends. Individual’s rights are respected and people receive a varied diet in accordance with their dietary needs. EVIDENCE: During discussions held with the three people using the service it was established that two people access external day services throughout the week and one person attends college twice a week and remains at home supported by staff for the remainder of the week. People also reported that they are members of evening clubs which they very much enjoy attending. Daily records seen indicate that people access a number of activities but that further opportunities could be explored. Surveys received suggest that individuals spend long amounts of time in their own rooms and one person stated that activities are ‘boring’ and that the individual is ‘dissatisfied’. Walton House DS0000030209.V351239.R01.S.doc Version 5.2 Page 14 Discussions held with one person clearly indicate that he wishes to pursue more meaningful activities and explore employment opportunities. He said that he would like to live more independently. Records on file evidence that this is being pursued however observations made during the inspection clearly evidence that staff are at risk of de-skilling him and not improving his overall independence skills. For example by staff preparing and cooking his meals despite him accessing a cookery course at college. This was fully acknowledged by the area manager during the inspection. A relative spoken to following the inspection also expressed concern in relation to this stating ‘X is capable of more if given the opportunity’. Discussions held with two of the people living at the home indicate they have regular contact with their family and a visitor’s book is held. Surveys that we received from relatives indicate that they are kept up to date concerning important issues. A charter of rights was seen in the home and daily records evidence that routines are flexible. People said that they help to keep their room tidy although discussions held indicate that more could done to empower individuals and promote independence. One report undertaken by a professional states the person ‘is able to carry out his personal and domestic activities of daily living. It is vital that he is encouraged to actively participate and take lead in all aspects of his life to avoid deskilling him’. We have received a concern about the quality of food provided for people in this service. Discussions indicate that following the appointment of the area manager menus have been revised and that people are now provided with greater opportunity to choose and plan menus and have a say about where food is purchased. More branded foods were seen readily available in addition to some fresh vegetables. The original menu was restrictive however records of food eaten suggest that people are provided with a balanced diet in accordance with their dietary needs. It was reported people are encouraged to eat healthy but have occasional treats. One person enjoys walking to the local shop to purchase provisions for the home. Walton House DS0000030209.V351239.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 and 20 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. The health and personal care that people receive is based on their individual needs and advice is sought from healthcare professionals to ensure their health needs are monitored. Staff understand the need to comply with safe medication systems however some current medication practices do not ensure all service users receive their prescribed medicines potentially placing people at risk. EVIDENCE: Preferences concerning personal care support needs were available on the files seen however the manager must ensure each individual has a detailed support plan which the area manager committed to undertake. People using the service indicated they were happy with the support they receive and appeared well presented. Records evidence that individuals have had recent input from an Occupational Therapist and a Speech and Language Therapist. Walton House DS0000030209.V351239.R01.S.doc Version 5.2 Page 16 Records clearly evidence that people are supported to access NHS Healthcare facilities and that people’s health is monitored at the required frequency and referrals made as appropriate. Health Action Plans were available on the two files examined and records evidence that dates have been scheduled for people to attend annual health reviews. Surveys received suggest that privacy and dignity is upheld. Training has been provided for staff in relation to one person’s health needs and discussions indicated that the service user played an active role in the training provided and received a certificate of attendance. Information concerning specific health needs was available on the two files examined. Medication procedures generally appeared satisfactory with the exception of one person not receiving all of his prescribed medicines for the two days prior to this inspection. It was reported that the person no longer requires all his medicine however there was no written evidence from the prescribing practitioner to support this. The acting manager committed to address this as a matter of urgency and request a medicine review. All staff have received accredited training in the safe handling of medicines and since the last inspection have attended training in the use of the monitored dosage system. The area manager was advised to review and update the homes medicines policy and ensure this includes a protocol for PRN medicines and homely remedies and to assess ongoing staff competency to administer medicines. Walton House DS0000030209.V351239.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 adequate This judgement has been made using available evidence including a visit to this service. People who use the service and their representatives are able to express their concerns and have access to a complaints procedure. Procedures to safeguard service users from potential abuse are in place but require further development. Staff are provided with the necessary training in adult protection to ensure they have the knowledge and an awareness of the referral process to safeguard the people using the service. EVIDENCE: The home has a complaints procedure in place and discussions held with the people who use the service evidence that they had an understanding of whom to approach if they were not happy with the service. The area manager intends to review the procedure and provide an easy read format for service users. No complaints were found recorded in the complaints log as stated in the providers self-assessment forwarded to us. We have not received any concerns or complaints in relation to this service since the last key inspection however daily records suggest that the home has supported one individual with a complaint. One survey we received and discussions held with a relative following the inspection indicate that concerns have been raised about lack of structure, meals, stimulation, staffing levels and deskilling individuals has yet to be resolved. Walton House DS0000030209.V351239.R01.S.doc Version 5.2 Page 18 The self-assessment that we received states the home has held meetings with day services and cleared the air to avoid unnecessary complaints made by new staff in day services who may not be familiar with service users characteristics. All staff have received training in Adult Protection, Recognising and Reporting Abuse provided by the Council. The area manager agreed to obtain a copy of the new safeguarding adults policy and procedure. It was also stated that staff have attended personal safety training in addition to dealing with violent incidents. Financial procedures were discussed with managers and recording systems examined. Although staff considered that procedures safeguard the people who use the service, a policy must be developed for the management of finances to ensure staff are clear about service users expenditure to include meals out, transport costs etc. Walton House DS0000030209.V351239.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 and 30 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. The environment lacks investment and although this does not pose a risk, it does not provide people with a comfortable and homely place to live. EVIDENCE: A full tour of home was undertaken accompanied by the area manager. Since the last inspection the house has been repainted externally and a ramp fitted to the front of the property to aid access. Although the home provides a comfortable place to live, many areas of the home and some soft furnishings appear tired and in need of upgrading as raised in previous inspection reports. The self-assessment states ‘The rooms and furniture could be of a much more robust nature to reduce deliberate breakages by service users; but this could be very expensive’. A maintenance and renewal programme has been developed as required by the previous inspection however some work has not been actioned within the given timescale. Walton House DS0000030209.V351239.R01.S.doc Version 5.2 Page 20 The area manager stated that a budget has since been allocated and each room is to be redecorated and furniture replaced in consultation with the people who use the service. The home was found clean and tidy during this unannounced inspection. Staff have received training in relation to infection control procedures. Managers intend to develop a cleaning schedule in conjunction with people using the service to develop their skills. Products hazardous to health are appropriately stored and data sheets available. The area manager committed to ensuring paper towels are readily available. Walton House DS0000030209.V351239.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): 32,33 and 35 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People who use the service are supported by a trained, committed staff team who have a good understanding of their individual needs. EVIDENCE: Discussions held with the area manager and observations made evidence that staff are committed to their work and have a good understanding of the needs of the people they support. The area manager stated that she ‘is proud of the team who provide very good care’. It was acknowledged that staff should do more to empower the people they support and the area manager committed to reviewing this. A member of staff was observed interacting positively with the people using the service and service users said that ‘staff are very nice’, ‘they are kind to me’. Surveys state ‘staff always treat by brother well and carers listen’, ‘the staff are very friendly’. It was reported of the four support staff employed, two hold a recognised care award known as a National Vocational Qualification and two have registered to start the award. The senior support worker reported that she holds NVQ at levels 2 and 3 and is due to start level 4 in March 2008. Walton House DS0000030209.V351239.R01.S.doc Version 5.2 Page 22 The team consists of a registered manager, one senior support worker and three support staff. The staff rota was examined and evidenced that staff are working long hours, which the area manager intends to address in addition to revising staff rotas to include full names, contracted hours and positions. The usual staffing ratio is one member of staff to three service users. Surveys we received and discussions held indicate that staffing levels could be improved one person stated the home could improve by providing ‘More staffing per shift’. Another person reported that ‘staff are not always readily available’. The self assessment (AQAA) completed by the provider states ‘We could provide more individualised care by employing more staff; but this is financially restricted’. It was stated that no new staff had been employed since the last inspection thus providing consistency of care for the people using the service. The homes recruitment procedures were therefore not examined on this occasion however surveys received from three staff indicate that all pre-recruitment checks were carried out prior to them starting work with service users. The AQAA states ‘Staff training has significantly improved, mandatory and service specific training which has benefited the staff team in supporting residents in the home’. Training was discussed with a member of staff on duty who confirmed that her training in safe working practices was up to date and that she had received other training in dementia care, diabetes and responding to violent incidents, as evidenced in certificates seen on file. Individual training records were available in addition to an overall team-training matrix. Surveys that we received from staff indicate that they are provided with training relevant to their role and the needs of the people they support. The provider appears committed to providing a qualified and trained workforce. Walton House DS0000030209.V351239.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): 37,39 and 42 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Senior managers have a clear understanding of the areas in which the service needs to improve in the best interests of service users. Quality assurance systems require further development to assess performance and evaluate outcomes for people using the service. Health and safety arrangements are generally satisfactory however assessments to support risk taking and safe working practices need to be further developed to safeguard people using the service and the staff group. EVIDENCE: Walton House DS0000030209.V351239.R01.S.doc Version 5.2 Page 24 Mrs Sharma is the Registered Manager and was on leave at the time of the inspection however the former deputy manager and new Area Manager assisted with the inspection. Mrs Sharma has obtained NVQ 4 Registered Managers Award and since the last inspection she has undertaken training to include IOSH Managing Safely, Dementia Care, Dealing with violent incidents and diabetes awareness. Surveys to gain the views of people using the service, their relatives and stakeholders have yet to be distributed however the area manager committed to undertake this in the new year in addition to the visits and reports required under Regulation 26. The service has produced a basic annual development plan as required by the previous inspection. Records evidence that people using the service are regularly reviewed by the home in conjunction with significant others. Records examined evidence that health and safety checks are carried out at the required frequency. Assessments to support risk taking and for safe working practices to include radiators require further development, which the area manager committed to doing. A food hygiene inspection was undertaken by the Environmental Health Department in May 2007 and found satisfactory. The Fire Officer has not visited the home however providers reported that they intend to contact the fire officer shortly to discuss current fire safety arrangements. The registered manager holds the IOSH certificate in Managing Safely and staff have attended training in safe working practices. The area manager reported that it is intention to introduce monthly safety checks and agreed to follow up the issue identified on the electrical hardwiring certificate and to ensure a copy of the revised health and safety policy is readily available. Walton House DS0000030209.V351239.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 3 5 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 2 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 3 34 x 35 4 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 x 2 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 4 2 x 3 x 2 x x 2 x Walton House DS0000030209.V351239.R01.S.doc Version 5.2 Page 26 No 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 YA9 Regulation 13 (4)(b) Requirement Identified risks must be assessed and regularly reviewed to ensure service users are not placed at risk of harm or neglect. The prescriber’s directions in relation to medication must be adhered to meet individual health needs. If it appears that the directions are not appropriate for the circumstances of the service user then the GP must be consulted. The home’s premises must be suitable for its stated purpose, safe and well maintained to ensure service users are not placed at risk. Timescale for action 01/01/08 2 YA20 13(2) 10/12/07 3 YA24 23(2) 01/02/08 Walton House DS0000030209.V351239.R01.S.doc Version 5.2 Page 27 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 2 Refer to Standard YA6 YA14 Good Practice Recommendations Support plans should be further developed to ensure staff are provided with detailed information to effectively support the individual needs of service users. People should be provided with greater opportunities to partake in structured and meaningful activities both inhouse and the community in accordance with their preferences. Furniture and fittings should be sufficient, safe and suitable to meet individual needs of people accommodated. A policy for the management of finances should be developed at the earliest opportunity to ensure staff are fully informed of the procedures for dealing with peoples finances. 3 4 YA26 YA23 Walton House DS0000030209.V351239.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Birmingham Office 1st Floor Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ 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 Walton House DS0000030209.V351239.R01.S.doc Version 5.2 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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