Inspection on 09/05/07 for Whiston House

This inspection was carried out on 9th May 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 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Whiston House 15/12/06

Whiston House 22/11/05

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

1 Marten Road

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

CARE HOME ADULTS 18-65 Whiston House Whiston Avenue Bethersden Ashford Kent TN26 3LA Lead Inspector Michele Etherton Key Unannounced Inspection 9th May 2007 10:50 Whiston House DS0000065343.V335527.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 Whiston House DS0000065343.V335527.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. Whiston House DS0000065343.V335527.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Whiston House Address Whiston Avenue Bethersden Ashford Kent TN26 3LA 01233 820912 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) CareTech Community Services (No.2) Ltd Post Vacant Care Home 15 Category(ies) of Learning disability (14), Mental disorder, registration, with number excluding learning disability or dementia (1) of places Whiston House DS0000065343.V335527.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. To accommodate one Service User over the age of 65yrs of age whose date of birth is 30/05/1941. 15th December 2006 Date of last inspection Brief Description of the Service: Whiston House is a care home that is registered to provide accommodation, personal care and support for up to 15 young adults. It is situated in the village of Bethersden, close to local amenities and approximately nine miles from Ashford. Whiston house is a listed building and the accommodation is arranged over three floors. The home has recently completed alterations to the home to allow for the residents to live in two units of six service users in a more homely environment. There is also accommodation in the ‘coach house’ within the grounds for two residents. The home has no lift. There is currently no Registered Manager for the service. Ms S. North is acting manager in day to day control and has been in post since March 2006. Fees for this service range between £720.55-£1345.88 per week. A varied programme of activities is available, individual residents directly fund some of which. Whiston House DS0000065343.V335527.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced site visit took place on 9th May 2007 between 10.50 am –4.10 pm as part of a key unannounced inspection. All key standards have been assessed in addition to those where there are outstanding recommendations or where outcomes became apparent during the course of the inspection. Time was spent talking with the acting manager and staff. Opportunities to discuss with those living in the home and their experiences were limited, and as at the time of writing the report no responses have been received to surveys forwarded to relatives and health and social care professionals about this service. What the service does well: What has improved since the last inspection? What they could do better: The home are required to evidence that: . An assessment of need is undertaken for all people admitted/transferred Prior to their admission to ensure the home can support them appropriately. . . Medication is stored appropriately and safely. There is ongoing and sustained maintenance of the Environment, equipment Etc to promote and protect health & safety . All care staff are provided with mandatory and specialist training, and that this is given in a timely manner to meet the needs of people in the home. Whiston House DS0000065343.V335527.R01.S.doc Version 5.2 Page 6 . The home must address fire safety and servicing shortfalls in addition to those already identified that impact on the health safety and welfare of people living in the home. Recommendations have also been made for improvements to information provided to prospective clients in respect of additional costs payable by them. That the home continue to rationalise care plans, implement additional improvements to medication administration arrangements, progress towards appointing a registered manager, and improve consultation processes and analysis of feedback for quality assurance purposes. 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. Whiston House DS0000065343.V335527.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Whiston House DS0000065343.V335527.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3 People who use this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. Information about the home should be reviewed to provide clarity around additional costs for which people in the home are responsible. There is a lack of assessment information to support recent transfers of people to the home, There is a lack of consideration as to whether staff have the necessary competencies, or that the environment is suitable to support new admissions. EVIDENCE: The home must ensure that people who may come to live at the home are fully apprised of all information relating to additional costs that they will be responsible for funding from their own personal monies, these additional costs must be clearly outlined within Statement of Purpose and user guide information. Since the last inspection two people have transferred to the home from another in the Homes group with the transfer of a further person planned shortly. All three have specialist needs over and above their learning disability. Of the two recent admissions only one had a prior opportunity to visit once before admission. “We were given very little information about the person, they were just dropped off one day by the other home”. Whiston House DS0000065343.V335527.R01.S.doc Version 5.2 Page 9 Files viewed contained no evidence of planning towards the move or a reassessment of need by Whiston House, a staff-training matrix indicates an absence of specialist training to ensure specialist needs can be met effectively. The home must evidence clearly that movement of people between homes or to semi-independent units within homes is as a direct result of reassessment of needs and consultation with all interested parties prior to moves taking place and a requirement has been issued regarding this. Whiston House DS0000065343.V335527.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9. People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. Support plans mostly reflect the needs and support required by people living in the home. Opportunities to make decisions and choices and take risks are encouraged and supported by the home; changes in these areas need to be evidenced in a timelier manner. EVIDENCE: The files of people living in the home are still in lever arch files and the previous recommendation to rationalise them has not been implemented and remains ongoing. Support plans viewed are generally to a good standard and reflect support needs in a person centred style, staff are still to receive training in person centred planning. One case tracked file of someone who has recently transferred to the home indicated that support plan and risk assessment information for this individual has not been updated to reflect these changes, Whiston House DS0000065343.V335527.R01.S.doc Version 5.2 Page 11 and the manager was asked to ensure this is addressed as a priority. Support plans would also benefit from an improved understanding and awareness by staff of specialist needs and how to support them. Observations of staff interactions with people living in the home and conversations with others during the course of the visit confirmed that there are opportunities for them to make choices and decisions during their day-today routines. A review of documentation indicated that there is a risk strategy in place, and there was evidence that risk assessments are reviewed, the home has generic and individual risk assessments but need to ensure that generic risk assessments are relevant and reviewed on an individual basis. Those newly admitted to the home have risk assessments in place from their previous placement but this has not been updated to reflect their changed environment and how this might impact on risks, this should have been undertaken prior to their admission to the home, and the manager has agreed to update these as a priority. Whiston House DS0000065343.V335527.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17 People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. People living in the home have access to a varied programme of activities. The home positively promotes contact with families. The development of some independence skills is encouraged, but could be expanded upon. The home provides a varied menu in keeping with the preference of people living in the home. EVIDENCE: The home has a varied range of leisure and community activities on offer to people living at the home, and provide transport to enable people to access the community. Transport is provided at a cost to the service users, as are most of the activities, the home needs to ensure that costs are clearly highlighted within user guides and SOP. The Home has a nice busy atmosphere, with lots of activity in some areas and in others quiet and peaceful. Some service users were participating in activities during the site visit, and others confirmed that they visit the day centre during Whiston House DS0000065343.V335527.R01.S.doc Version 5.2 Page 13 the week. Staff spoken with reported that the day centre was a good resource, but thought some improved planning around the range and appropriateness of some activities needed to reviewed to ensure that it was a worthwhile and stimulating experience for those attending. “I sometimes feel that people are just sitting around at the day centre, because they can’t do the activity on offer, I think they should offer more appropriate activities”. Staff reported that many of the service users retain close contact with families and many bedrooms visited displayed family photos, or mementos. In conversation staff and some of the people living in the Home confirmed that visits and stays with family are arranged on a regular basis, and are supported by the home. Some people living in the home retain their own bedroom keys. Discussions with some staff indicated their attempts to promote independence and involve people more actively in daily living activities e.g. involvement in meal preparation, laundry etc, clearly this is an area that could be expanded upon within daily routines. There are restrictions on people living in the home going outside the home on their own unless assessed to do so, generally people make good use of the space within the units and move freely between personal and communal space, they would all benefit from having access to the large rear garden, which is secure but currently in a poor state and inaccessible. Dining areas are pleasant and homely, Kitchens are located in both units and the coach house, access to all but the coach house kitchen are restricted except under staff supervision, although opportunities are offered to involve people in meal preparation, cooking dishes etc. Staff record likes and dislikes around food preferences, people living in the home who were able to comment said they liked the food. Some special diets are catered for. Whiston House DS0000065343.V335527.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. Personal support is provided to most people in a manner that staff deem is in keeping with their individual preference; omissions in specialist staff training may compromise this. People living in the home have access to routine healthcare. Shortfalls in the safe storage and administration of medication could place people living in the home at risk. EVIDENCE: Case files viewed indicated support plans were reflective of personal care support needs, in most cases. Staff have identified some previously unknown support issues with a person who has recently transferred to the home, conversation with staff indicated good analysis and problem solving around the issue with staff taking the initiative as to how to manage support for this new need, this now needs to be clearly written down to ensure all staff are consistent in the support provided. Staff demonstrated an awareness of changing needs, and the necessity for equipment, training, and increased or decreased support for some people. Omissions in some staff core and specialist training could compromise the quality of support experienced by people in the home Whiston House DS0000065343.V335527.R01.S.doc Version 5.2 Page 15 Support plan files of case tracked people who live in the home provided details of wishes in the event of their death. There was evidence of access to routine health care, the manager raised concerns at the unwillingness of some GP’s to visit the house if a person with challenging behaviour was too unsettled to take to the surgery, it was suggested that the manager raise these concerns with the local PCT. Staff have not been trained to support some specialist healthcare needs e.g. Diabetes, epilepsy, brain injury. The home has purchased some special equipment for one person. The Home has experienced a number of medication errors over a period of months and has taken appropriate action to investigate these and to improve staff competency where this has been highlighted, despite these measures some errors have continued and the home must continue to monitor staff competency and ensure that administration of medication is managed safely. Observation of a medication round including completion of MAR sheets and storage of medication has been undertaken as part of this site visit, this highlighted some shortfalls in the storage of medication, these are: Security The security of the window is unsatisfactory. Hygiene within the Medication room – the room is in a poor state of décor with dirty walls and an unfinished light fitting on the ceiling. The rubbish bin is unsuitable and is not compliant with infection control standards, the bin was overflowing with rubbish some of which had fallen on the floor, there are no hand drying facilities for staff to promote good hand-washing, used and new medication blister packs are stored in bags on the floor. The medications cabinet is located on the wall and subject to full sunlight from the window; there is no thermometer for staff to check room temperatures in the summer months in particular. The Home is required to address the highlighted shortfalls. Mar sheets provided evidence of booking in of medications and medication profiles were noted in user files. An audit of a sample of liquid medication was undertaken and found to be accurate; the home is advised to implement regular audits of all medications not in blister packs and liquid medications. It is further suggested that the home develop individual PRN guidelines in addition to existing medication profiles and that these are kept with MAR sheets for reference. Medication keys are kept securely but would benefit from colour coding to make them easier for staff to locate on bunches of keys. These are recommendations for improved practice. Whiston House DS0000065343.V335527.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 People who use this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. Opportunities exist for people living in the home to express their concerns and have them resolved. Shortfalls within staff training and some inappropriate placement could place people in the home at risk. EVIDENCE: The Home has received two complaints since the last inspection, from representative of people living in the home; these have now been dealt with satisfactorily. People living in the home are provided with copies of the complaints procedure and the manager advised that this is gone through with individuals in their private talk time with staff, it was unclear how issues raised in talk time would be dealt with. Observations of people living in the home indicated they are relaxed and comfortable around staff, and would seem to have no problem approaching them. The home currently has an open adult protection involving two service users this has been investigated. A review of the staff training matrix provided with pre inspection information from the home indicates that out of a staff team of 21, more than 1/3 are still to receive adult protection training, with six now due refresher training, half of the staff team are still to receive NCVI training despite some residents being written up for holds that staff are not trained to do, this includes a case tracked person whose key worker is untrained in NCVI. Whiston House DS0000065343.V335527.R01.S.doc Version 5.2 Page 17 On the day of the visit only 2 of those on duty had received NCVI training, the acting manager has identified this as a priority area of staff training. Service users with challenging behaviour and staff may be placed at risk with current shortfalls in staff training to effect appropriate approved control when needed in a safe manner. Staff are still to receive specialist training to those people living in the home with specialist needs e.g. Brain injury, diabetes, epilepsy, autism, a lack of understanding and awareness by staff may place service users at risk. Current nighttime staffing arrangements need to be reviewed in respect of two people living in the coach house whose needs indicate they may be at risk of harm if left unsupervised. The use of a baby monitor for one person also needs review as its original purpose is now no longer valid and its continued use therefore could be viewed as an invasion of privacy. The expectation that people living in the home will be financially responsible for most of their activities, lunches out, additional bedding, transport and evening social activities e.g. summer ball, needs to be clearly stated with SOP and user guide information and the home should review this documentation accordingly. Whiston House DS0000065343.V335527.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 26,28,29,30 People who use this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. The home offers a pleasant, clean and homely environment to the people living there, however their safety could be compromised by a failure to sustain upgrading, routine maintenance, and attending to fire safety. EVIDENCE: The Home would benefit from a sustained programme of maintenance. External windows and sills are in need of some painting. One windowpane is broken in the downstairs office. The home has been redecorated to a good standard in September 2006, this is beginning to show some signs of wear, and there is substantial cracking of plaster around some door frames and in some bedrooms in the ground floor unit, it was suggested that the home may wish to obtain the view of a surveyor to ensure that there is no movement of the building that may compromise safety. Whiston House DS0000065343.V335527.R01.S.doc Version 5.2 Page 19 Communal spaces are very pleasant and furnished to a good standard with quality furnishings. Most bedrooms have ensuites and are single occupancy, some items of broken furniture have not been replaced and could pose a health and safety issue for the people residing in those bedrooms. Bedrooms are personalised and many contain evidence of family contacts and reflect personal interests and hobbies, family photographs and pictures etc are absent from walls following the refurbishment and these now need to be put back. Not all bedrooms are furnished to the minimum standard and where there are omissions this should be clearly evidenced within files and the reasons why. Some people have purchased items of their own furniture and this is recorded. Maintenance within the home is not sustained and is reactive rather than part of a programme of maintenance. The home has a number of outstanding areas of maintenance. The garden is overgrown and inaccessible to the people in the home. Items of broken furniture have been stored in the garden area for the coach house and as well as being unsightly they could pose a health and safety hazard to the two people who live there. Some magnetic door closures are broken on bedroom doors. The fire officer visited in March 2007 and has issued a significant number of requirements to be addressed by 23/5/07, as of the date of this visit no action has been taken to address these shortfalls. The home must ensure and evidence that communal equipment e.g. wheelchairs, bath hoists is appropriately serviced. The Home was clean, tidy and warm on the day of the site visit, staff reported that they have access to gloves, aprons etc to undertake personal care for people in the home. Infection control is not fully promoted with toilet rolls lying on floors because they do not fit the holders, hand-dry facilities are absent in both laundry areas, there are no pedal bins for disposal of used gloves, paper towels etc. To ensure that the safety and welfare of people in the home are promoted and protected, the home is required to address the shortfalls in maintenance of the building, and the garden highlighted. Whiston House DS0000065343.V335527.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35,36, People who use this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. People living in the home are protected by the implementation of a robust recruitment procedure; however, the quality of care and support they receive could be compromised by shortfalls in mandatory and specialist training for care staff. Care staff have access to regular supervision and feel supported. EVIDENCE: The acting manager reported that she is currently updating the training matrix. Records of training provided prior to inspection by the home, indicate that 40.9 of staff are trained to NVQ2. Several more staff are registered to commence the course shortly. Numbers of staff are generally adequate with three on each floor in addition to the manager and deputy. Two people living in the home are funded to receive some 1-1 staff time and the manager felt this is achievable within current staffing levels. It is too soon to know what impact the current acting manager is having on the practice within the home but staff spoken with generally reported that they felt supported. Whiston House DS0000065343.V335527.R01.S.doc Version 5.2 Page 21 Recruitment files viewed demonstrated that people living in the home are protected by a robust procedure of vetting and checks; some minor improvements to documentation were suggested e.g. current photographs of staff. A system is in place for ensuring that nominated drivers have current licences and these are checked six monthly. Whilst there is a good percentage of staff who have achieved most mandatory core skills, staff turnover has meant that a number of staff have still to achieve one or more core training areas, in addition 1/3 of staff have not received adult protection training and more than half are still to receive NCVI training. Some people in the home have behaviour guidelines that approve the use of holds that most staff are untrained to perform. A previous recommendation in respect of staff training has not been addressed. The home is required to ensure that staff’ receive mandatory and specialist training in a timely manner that enables them to appropriately and safely support people living in the home. A satisfactory system of formal supervision is in place and timescales are generally being maintained. Discussions with staff indicated a general feeling of being supported, and that opportunities exist for them to raise issues both in supervision and in team meetings. “ I feel well supported by the company”. “We all get on well as a team” Whiston House DS0000065343.V335527.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37.39.42 People who use this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. There is currently no permanent and registered manager in post. The quality assurance system needs strengthening to clearly evidence consultation with people in the home and other stakeholders and how their views influence service development. The health and safety of people living in the home is not sufficiently promoted or protected EVIDENCE: A previous recommendation in respect of the registered manager position has not been addressed and is ongoing. There is currently a new acting manager, but there is a lack of clarity as to how long she will remain at the home, or the longer-term management of the home. Whiston House DS0000065343.V335527.R01.S.doc Version 5.2 Page 23 Quality assurance systems are under review by the company who will be implementing a system of self-audit; there is currently no service development plan in place. Whilst there are some opportunities for staff and people living in the home to be consulted, this needs to be expanded to all stakeholders including relatives and health and social care professionals. It is recommended that the home implement systems for wider consultation with all stakeholders and undertake appropriate analysis of feedback. Information provided by the home prior to the site visit highlighted gaps in servicing of the gas supply and electrical installation. The site visit has highlighted a lack of timely response to routine maintenance issues that impact on the people living in the home e.g. the garden has not been accessible to residents in the home for more than three months; door closures that meet fire safety requirements have been left unattended. Items of broken equipment and furniture have been left in an area of garden that is accessed by some of the people living at the home. Tests of fire points and emergency lighting are undertaken routinely and a new fire risk assessment has been completed, fire fighting equipment has been serviced, a recent visit by the fire officer has however, highlighted a number of fire safety requirements that must be addressed by 23rd May, 2007. To date none of these requirements have been addressed, and this matter has been referred back to the fire officer. The home operates a good system of checking staff driving licences on a six monthly basis, and vehicle checks are undertaken on a weekly basis of those vehicles used for transporting people living in the home. Shortfalls in completion by all staff of basic core skills and the provision of relevant specialist training may impact on the health, safety and welfare of people living in the home. The home is required to address all identified shortfalls within the report to ensure that the health safety and welfare of people living in the home is fully promoted and protected. Whiston House DS0000065343.V335527.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 2 2 3 2 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 2 25 X 26 3 27 X 28 3 29 2 30 2 STAFFING Standard No Score 31 X 32 2 33 X 34 3 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 2 X 2 X X 1 X Whiston House DS0000065343.V335527.R01.S.doc Version 5.2 Page 25 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 YA2 Regulation 14 Requirement Timescale for action 30/06/07 2 YA20 13(2) Home to ensure that a robust assessment of need is undertaken for all admissions and transfers and takes account of whether environment and staff competencies are appropriate prior to admission taking place. 30/06/07 The security of the window in the medication room is unsatisfactory. The hygiene of the medication room must be reviewed and take account of the poor state of décor, management of rubbish, promotion of good hand-washing and effective infection control, review storage of used and new medication bags, evidence recording of temperatures. The home to address shortfalls in 30/06/07 maintenance, and upgrading of the building and garden as highlighted in the report. The home is required to ensure 31/07/07 that staff’ receive mandatory and specialist training in a timely manner that enables them to appropriately and safely support DS0000065343.V335527.R01.S.doc Version 5.2 3 YA24 23(1)(2) 4 YA35 18(1)(a) Whiston House Page 26 people living in the home.’ 5 YA42 13(4)(a-c) The home is required to address 31/07/07 identified shortfalls to ensure that the health safety and welfare of people living in the home is fully promoted and protected at all times. These are: Provide evidence of routine servicing of the gas supply and electrical installation and equipment for the use of people in the home. Timely response to maintenance issues that impact on the people living in the home, shortfalls in environment addressed. Address fire safety requirements within timescales given by the fire officer. Address shortfalls in completion by all staff of basic core skills and the provision of relevant specialist training. 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 YA1 YA6 Good Practice Recommendations Home to review SOP and user guide to ensure that additional costs to people living in the home for activities, additional bedding, transport, holidays etc are made clear Manager agreed to review and rationalise service user files to manageable working documents. Support plans of those transferred need updating as a priority. Home to implement audits of all medications not in blister DS0000065343.V335527.R01.S.doc Version 5.2 Page 27 3 YA20 Whiston House packs and liquid medications on a regular basis. PRN guidelines to be developed for individual users and those these and medication profiles are with medication sheets for easy reference. Colour code medication keys for ease of finding by staff 4. 5 YA37 YA39 There is currently no registered manager The home to implement systems for wider consultation with all stakeholders and undertake appropriate analysis of feedback. Whiston House DS0000065343.V335527.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Whiston House DS0000065343.V335527.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. 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