Care Home: 1 Middlefield Close

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What the care home does well Individuals are able to exercise choice in their daily lives, maintain bonds with family and friends and take part in social, cultural, religious and recreational activities. Rights of choice, privacy and dignity are promoted. The homes complaints procedure is an accurate document for individuals to express any concerns or complaints and individuals are protected from abuse and harm by the homes policies and procedures. Individuals are encouraged to be involved in the running of the home and maintaining their daily living skills and a choice of a healthy diet is provided. The home has a full staff team which continues to offer the supported people continuity of care and support. What has improved since the last inspection? The Statement of Purpose and Service User Guide have been reviewed since the last inspection to ensure that the documents are written in a way which people could understand for example with the use of photos and pictures. The support and personal care that people receive is based on their individual needs set out in their care plans and arrangements for peoples care plan reviews is robust. Monitoring of risk assessments is well managed to ensure the safety of individuals. Individual`s physical, emotional and health care needs are monitored and met and well recorded. The homes medication procedures ensure that medication is administered to all individuals in a safe and appropriate way. During the tour of the premises the inspector observed that the home was well maintained and requirements regarding the homes environment and equipment had been met. Recruitment practices are well managed to ensure the protection of individuals from abuse and harm. A significant effort has been made by the registered manager and staff to develop a system whereby the homes records and office space is more effective which has promoted the overall efficiency and robust management of the home. Accident and incident records were sampled and demonstrated that the homes staff had improved in giving notice to the commission without delay regarding any event, which affects the safety and welfare of the supported people. Staff were observed to be wearing protective clothing for example plastic aprons and gloves and arrangements for the prevention of spread of infection in the home had been strengthened. What the care home could do better: Arrangements must be made to ensure that all staff receive mandatory training in order to ensure the safety and well being of individuals in their care. CARE HOME ADULTS 18-65 1 Middlefield Close Middlefield Farnham Surrey GU9 8RS Lead Inspector Suzanne Magnier Unannounced Inspection 11 August 2008 09:30 th 1 Middlefield Close DS0000013438.V368910.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 1 Middlefield Close DS0000013438.V368910.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. 1 Middlefield Close DS0000013438.V368910.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 1 Middlefield Close Address Middlefield Farnham Surrey GU9 8RS 01252 718479 F/P 01252 718479 kim.doody@dimensions-uk.org www.new-support.org.uk Dimension (NSO) Ltd 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) Kim Jacquelyn Doody Care Home 5 Category(ies) of Learning disability (5) registration, with number of places 1 Middlefield Close DS0000013438.V368910.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: 2. Learning disability (LD) The maximum number of service users to be accommodated is 5. Date of last inspection 16th August 2007 Brief Description of the Service: 1 Middlefield Close is a purpose built, detached bungalow set in a private residential cul-de-sac, located close to the town of Farnham. London and Quadrant Housing Association own the home. Dimensions manage and provide accommodation and care for up to five people with learning disabilities and/or physical disabilities. All areas of the home are easily accessible and the doors and hallways are wide enough for wheelchair access. Communal areas are arranged and furnished in a comfortable, homely way and there are ample toilet and bathing facilities. All bedrooms are single and of a good size, and all have a wash basin. No rooms have en-suite facilities. There is a garden to the rear of the property that is fully accessible to the supported people and there is parking for the homes adapted vehicle and cars to the front of the building. The current charges per week are £1,070.00 to £1,300.00 1 Middlefield Close DS0000013438.V368910.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Commission has, since the 1st April 2006, developed the way it undertakes its inspection of care services. This inspection of the care home was an unannounced ‘Key Inspection’. Some additional standards were assessed and have been included within the report. Following the previous key inspection in August 2007 the service has met all the requirements made. Ms S Magnier Regulation Inspector carried out the inspection and the homes registered manager represented the service. For the purpose of the report the individuals using the service are referred to as supported people. The inspector arrived at the service at 09.30 and was in the home for five and a half hours. It was a thorough look at how well the home is doing. It took into account detailed information provided by the home and any information that CSCI has received about the service since the last inspection. The commission received seven staff written surveys and two surveys from health care professionals. The comments of which have been included within the report. The inspector spent time talking to people living at the home and several visitors in the home in order to gain their views and opinions about the service. All people spoken with spoke positively and people observed were relaxed and at home within their surroundings. The inspector looked at how well the service was meeting the standards set by the government and has in this report made judgments about the standard of the service. Documents sampled prior and during the inspection included the homes Statement of Purpose and Service User Guide, care/person centred plans, risk assessments, medication procedures, staff files, a variety of training records, and several of the services policies and procedures. No complainant has contacted the Commission with information concerning a complaint made to the service since the last inspection. The home had submitted the Annual Quality Assurance Assessment (AQAA) prior to the inspection, which was well written to inform the commission about the service and some details of document have been added to the report. From the evidence seen by the inspector and comments received, the inspector considers that the home continues to be able to provide a service that meets the needs of people who have diverse religious, racial or cultural needs. 1 Middlefield Close DS0000013438.V368910.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? The Statement of Purpose and Service User Guide have been reviewed since the last inspection to ensure that the documents are written in a way which people could understand for example with the use of photos and pictures. The support and personal care that people receive is based on their individual needs set out in their care plans and arrangements for peoples care plan reviews is robust. Monitoring of risk assessments is well managed to ensure the safety of individuals. Individual’s physical, emotional and health care needs are monitored and met and well recorded. The homes medication procedures ensure that medication is administered to all individuals in a safe and appropriate way. During the tour of the premises the inspector observed that the home was well maintained and requirements regarding the homes environment and equipment had been met. Recruitment practices are well managed to ensure the protection of individuals from abuse and harm. A significant effort has been made by the registered manager and staff to develop a system whereby the homes records and office space is more effective which has promoted the overall efficiency and robust management of the home. Accident and incident records were sampled and demonstrated that the homes staff had improved in giving notice to the commission without delay regarding any event, which affects the safety and welfare of the supported people. 1 Middlefield Close DS0000013438.V368910.R01.S.doc Version 5.2 Page 7 Staff were observed to be wearing protective clothing for example plastic aprons and gloves and arrangements for the prevention of spread of infection in the home had been strengthened. 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. 1 Middlefield Close DS0000013438.V368910.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 1 Middlefield Close DS0000013438.V368910.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, 5. People who use the service experience good quality outcomes in this area. This judgement has been made using a range of evidence including a visit to this service. People and their representatives have information about the home in order that they can make an informed choice about moving to the home. The homes admission and assessment procedures ensure that individual’s needs are appropriately identified and met. Contracts are available to supported people in order that they know their rights of residency. EVIDENCE: The Statement of Purpose and Service User Guide have been reviewed since the last inspection to ensure that the documents are written in a way which people could understand for example with the use of photos and pictures. The registered manager advised that the service has not received any admissions since the previous inspection and discussed the homes policy and procedure with regard to people moving into the home. The manager remains knowledgeable about the criteria and the importance of a persons needs being assessed prior to admission to the home in order to ensure that staff could meet the needs and aspirations of the individual. 1 Middlefield Close DS0000013438.V368910.R01.S.doc Version 5.2 Page 10 One individual’s terms and conditions/ contract of residing in the home were sampled. Written guidance was available to explain the breakdown of costs and the contract had been signed by the supported person. 1 Middlefield Close DS0000013438.V368910.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9. People who use the service experience good quality outcomes in this area. This judgement has been made using a range of evidence including a visit to this service. The support and personal care that people receive is based on their individual needs set out in their care plans and arrangements for peoples care plan reviews is robust. Monitoring of risk assessments is well managed to ensure the safety of individuals and peoples dignity and respect is consistently promoted. EVIDENCE: A significant improvement has been made since the previous inspection to ensure that supported peoples care plans are better managed, kept under review and reflect the current support needs of the supported person. Individuals person centred plans have been maintained by the homes staff and each supported person, if they choose, has their plan displayed in their bedroom. It was evident that whilst speaking with individuals in the home that their plan had been developed with them and included a variety of aspects of their life including their dreams and aspirations, likes and dislikes, social 1 Middlefield Close DS0000013438.V368910.R01.S.doc Version 5.2 Page 12 and cultural history, family and friends. The documents have continued to be thoughtfully presented and include pictures and photographs which offer the reader an insight into the individual’s life. The care plans contained clear and well-written guidelines for the homes staff to read which continued to enable them to provide care in the way the supported individual preferred. These choices of the person’s lifestyle were included and documented in the form of a 24 - hour breakdown of their day and it was evident that the supported person, where able, had been involved in the development of their care plans. Agreed working practices and guidelines have been maintained to support the individual if they individual should become distressed and what actions staff should take to reduce the distress or anxiety. Comments received by staff regarding the care plans stated ‘All care plans are reviewed each month and updated so I feel the staff are well informed of changes’. ‘Care plans are also reviewed and updated if required every month. Each person we support has a PCP, (person centred plan) which is reviewed and updated if required every month’. ‘The service meets the individual needs pf all people we support and is person centred’. Comments received from a staff member included ‘Active support enables service users to help staff around the house everyday. For example cleaning and cooking. I think it is great because it allows for more interaction between staff and service e users. It also provides for a homely environment where service users help with the running of their home’. Risk assessments were available in the files sampled by the inspector to demonstrate that the homes staffs are aware of the hazards in people’s lives and ways in which to reduce harm to the individual. The recording and management of the files had significantly improved and risk assessments had been signed and reviewed. 1 Middlefield Close DS0000013438.V368910.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, 15, 16, 17. People who use the service experience good quality outcomes in this area. This judgement has been made using a range of evidence including a visit to this service. Individuals are able to exercise choice in their daily lives, maintain bonds with family and friends and take part in social, cultural, religious and recreational activities. Individuals are encouraged to be involved in the running of the home and maintaining their daily living skills. A choice of a healthy diet is provided. EVIDENCE: Throughout the inspection it was observed that supported people were comfortable and happy in their surroundings and the staff were attentive to the needs of each individual. Colourful activity boards have been maintained and continue to be displayed in the kitchen with pictures and photos to identify what activities, hobbies and interests were taking place that day and also during the week. Two individuals 1 Middlefield Close DS0000013438.V368910.R01.S.doc Version 5.2 Page 14 told the inspector what they were doing during the day one of who used the display boards to show the activity. Whilst speaking with one individual and their relative it was evident that the home work closely with friends and family and relationships are maintained for the benefit of the supported person. Several supported people continue to be supported to visit and have overnight stays with relatives and two relatives spoken with during the inspection were very positive about the home and the care and support provided to their relation. The AQAA advises that the home has supported one individual to open their own business and in so doing pursue their hobby and interest. Individuals have opportunities to access further education, and to visit places in their community such as library, cinema, supermarkets, going shopping and take part in leisure activities. The spiritual needs of individuals continue to be met with staff promoting peoples rights to attend places of worship and make and maintain new friends and acquaintances. Throughout the day it was observed that individuals were able to move freely around their home. There was evidence to support that individuals are included in the running of the home and are involved in decisions this was demonstrated by a large colourful board in the kitchen which detailed activities, housekeeping tasks, planned leisure pursuits, cooking, menu planning, and gardening. The supported people have a rabbit called Cinnamon who also has a care plan and risk assessment and a rota with photos so individuals in the home know who has the responsibility of looking after him during the day. Staff on duty were observed as attentive and engaged with the supported people throughout the inspection. One person told the inspector that they like to listen to the music on the new TV and were looking forward to the Panto and helping to paint the scenic backgrounds. Comments from staff regarding the homes provision of activities included ‘It is difficult for the service users to access the community often as there is not usually enough staff on shift’. ‘I feel if more staff were employed service users needs would be more fulfilled for example they would be able to access the community on a more regular basis’. ‘What we could better is provide more staff so that the people we support could go out more. More holidays for the people we support.’ One health care professional’s written comments included ‘the home provides a good quality of care and support at all levels. It meets with the individuals requirements of each of its residents through healthcare, and ensures that each resident has a satisfactory choice of activities both in the home and outside to participate in should they wish’. 1 Middlefield Close DS0000013438.V368910.R01.S.doc Version 5.2 Page 15 The home have maintained a well organised way of including supported people in menu planning and showing people the menu by a variety of laminated photographs which illustrate the meals. One individual showed the inspector what they wanted for their evening meal and it was observed that a choice was available. The homes fridge was well stocked with fresh dairy products and vegetables and the kitchen served as a dining area. Records of fridge and freezer temperatures and food temperatures were available and well recorded. Several supported people were observed to be eating their meals independently with staff available should they need additional support. The staff meeting minutes indicate that staff are aware and support people with differing diets and are vigilant to people’s health in respect of diet. 1 Middlefield Close DS0000013438.V368910.R01.S.doc Version 5.2 Page 16 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20. People who use the service experience good quality outcomes in this area. This judgement has been made using a range of evidence including a visit to this service. Individual’s physical, emotional and health care needs are monitored and met. Choice and dignity is promoted and the homes medication procedures ensure that medication is administered to all individuals in a safe and appropriate way. EVIDENCE: The staff team consist of a multi racial mixed gender staff group and the manager advised that where possible gender based care is provided and staff are aware of the supported person’s individual preferences. It was observed that staff supported individuals in a sensitive way ensuring their privacy is respected when providing assistance with personal care. The care plans have been maintained and included records of health care appointments that had been attended. Health care professionals included general practitioners, chiropodists, dentist, dieticians, occupational therapists, and specialist health care personnel. The arrangements for individuals who cannot use the standing weighing scales 1 Middlefield Close DS0000013438.V368910.R01.S.doc Version 5.2 Page 17 to be supported at another Dimensions Home to have their body weight checked on scales has been maintained and records evidenced in individuals care plans. The general medication cupboard continues to be located in a safe and secure place and arrangements regarding stock medicine storage have improved following the previous inspection. The arrangements for a monitored dosage system remain in place and procedures regarding the safe handling, administration and disposal of medicines have been updated. The homes medication policy and procedure was robust and medication administration charts were well recorded, and records maintained, which clearly demonstrated the way the person preferred to take their medicines, the side effects and purpose of the medicine, the individual’s photo and any known allergies. Emergency cards have been maintained which included people’s medication and health needs, their allergies, photos and specific support needs regarding communication and health. 1 Middlefield Close DS0000013438.V368910.R01.S.doc Version 5.2 Page 18 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23. People who use the service experience good quality outcomes in this area. This judgement has been made using a range of evidence including a visit to this service. The homes complaints procedure is an accurate document for individuals to express any concerns or complaints. Individuals are protected from abuse and harm by the homes policies and procedures. EVIDENCE: The home has a clear complaints policy and procedure which has also been reviewed and developed since the previous inspection to more fully support individuals so that their views, opinions and complaints are recognised and acted upon. The manager confirmed that no complaints have been received by the home and no complainant has contacted the commission with information concerning a complaint made to the service since the last inspection. The AQAA details that no complaints have been received since the last key inspection. The manager demonstrated that she remains aware of the local authority’s multi agency procedures for safeguarding adults and there have been two safeguarding referrals one of which has been closed and one remains open. The home has a whistle blowing policy and procedure, which is available to staff in order to safeguard individuals in their care. The manager confirmed by records that all staff had received safeguarding vulnerable adults training and would feel confident to present in house safeguarding training to all staff. 1 Middlefield Close DS0000013438.V368910.R01.S.doc Version 5.2 Page 19 One health care professional’s written comments stated ‘There have never been any problems in my expressing any concerns to the homes manager should any arise concerning my treatments and subsequent visits’. 1 Middlefield Close DS0000013438.V368910.R01.S.doc Version 5.2 Page 20 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, 30. People who use the service experience good quality outcomes in this area. This judgement has been made using a range of evidence including a visit to this service. The physical layout and indoor and outdoor communal areas of the home enable supported people to live in a safe and well maintained environment and all areas of the home are clean and safe. EVIDENCE: During the tour of the premises the inspector observed that the home was well maintained and requirements regarding the homes environment and equipment had been met. Appropriate access remains available to all supported people in the home. An ongoing decoration programme has ensured that individual’s bedrooms and communal areas have been or are being decorated with evidence that the supported people have been included to make decisions and have choice regarding colours and furnishings. The front and back gardens continue to be well maintained and accessible for individual’s to use. 1 Middlefield Close DS0000013438.V368910.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, 34, 35. People who use the service experience adequate quality outcomes in this area. This judgement has been made using a range of evidence including a visit to this service. The homes staff provides 24-hour support to the individuals living at the home. Recruitment practices are well managed. The home has a robust induction programme yet mandatory training arrangements must be strengthened to ensure that peoples needs are met appropriately and safely. EVIDENCE: The home currently has a full staff team. On the day of the inspection there was four staff on duty. All staff were observed as skilled in supporting the people in their care and were knowledgeable regarding the specific needs of individuals to ensure their safety, well being and offer reassurance. Staff carry out all roles within the home, which include personal care, shopping, cooking, housekeeping and laundry as well as assisting individuals to social activities and transporting them to these. Written comments from staff about the staffing in the home stated ‘More staff employed would be beneficial to all’. ‘Provide more staff so that the people we support could go out more. More holidays for the people we support, cut down 1 Middlefield Close DS0000013438.V368910.R01.S.doc Version 5.2 Page 22 on unnecessary paperwork and better pay’. ‘We could do better by too much emphasis on NVQ and qualifications rather than on other capabilities. Not enough community support due to lack of staff ’. Following the previous inspection the home have met the requirement to improve the safe vetting and recruitment procedures. The home has a recruitment and selection policy, which incorporates equal opportunities. The inspector sampled one staff file, which contained an application form, with two references, evidence that face- to -face interviews had taken place and the job description in order that the staff member was clear about their roles and responsibilities. There was documented evidence that a CRB clearance had been obtained and evidence that an induction and some mandatory training had been undertaken. The staff training records evidenced that some staff had not received updated mandatory training and evidence was seen to support that although the training had been booked it had been cancelled. It is required that arrangements must be made to ensure that all staff receive mandatory training in order to ensure the safety and well being of individuals in their care. Comments received by staff regarding the homes training programme included ‘Training could be better’. ‘I attend training which is relevant to my job role on a regular basis. I recently attended Autism training as one person I support has autism. I feel the training was very helpful and has given me insight into how a person with Autism thinks and behaves.’ ‘Could do with more training.’ The AQAA identifies that 50 of staff have or are working towards achieving their National Vocational Qualification in Care (NVQ) awards. 1 Middlefield Close DS0000013438.V368910.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, 42. People who use the service experience good quality outcomes in this area. This judgement has been made using a range of evidence including a visit to this service. The management and administration of the home is robust. The home continues to be run in the best interests of the supported people and their views and opinions and those of others associated with the home are sought. Individual’s welfare is promoted through monitoring of health and safety in the home. EVIDENCE: The pace of the home continues to be designed to meet the needs of the supported people. It was evident through observation and talking with staff that the registered manager had good knowledge about managing the care home and had the skills and experience to ensure the safety and well being of all persons in the home. 1 Middlefield Close DS0000013438.V368910.R01.S.doc Version 5.2 Page 24 Comments received from relatives at the home during the inspection confirmed that the registered manager was approachable and that matters in the home had improved. One written comment from a health care professional stated ‘Caring environment, good communicators’. The registered manager has attained Level 4 National Vocational Qualification (NVQ) and Registered Managers Award. A significant effort has been made by the registered manager and staff to develop a system whereby the homes records and office space is more effective which has promoted the overall efficiency and robust management of the home. The manager confirmed that Dimensions continues to seek supported peoples, and their representative’s views and opinions about the service through the pictorial Quality Assurance booklets which are available. Food stored in the home’s refrigerator was labelled and stored in compliance with food hygiene standards and hot food temperatures had been recorded to ensure as far as reasonably practicable the home is free from hazards to the supported people. Accident and incident records were sampled and demonstrated that the homes staff had improved in giving notice to the commission without delay regarding any event, which affects the safety and welfare of the supported people. Staff were observed to be wearing protective clothing for example plastic aprons and gloves and arrangements for the prevention of spread of infection in the home had been strengthened. Hand washing facilities remain available throughout the home and clinical waste disposal is appropriately managed. Records indicated that servicing of fir equipment had taken place and health and safety checks had been undertaken and recorded. A current insurance indemnity certificate was displayed with the current certificate of registration. 1 Middlefield Close DS0000013438.V368910.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 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 3 X 3 X 3 X X 3 X 1 Middlefield Close DS0000013438.V368910.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 YA35 Regulation 18 (1) c (i) Requirement Timescale for action 12/10/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations 1 Middlefield Close DS0000013438.V368910.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Maidstone 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 1 Middlefield Close DS0000013438.V368910.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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