Care Home: 126 Cowdray Avenue

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What the care home does well What has improved since the last inspection? What the care home could do better: CARE HOME ADULTS 18-65 126 Cowdray Avenue Colchester Essex CO1 1XX Lead Inspector Tim Thornton-Jones 22 nd Unannounced Inspection September 2006 09:30 126 Cowdray Avenue DS0000017717.V310383.R02.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 126 Cowdray Avenue DS0000017717.V310383.R02.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. 126 Cowdray Avenue DS0000017717.V310383.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 126 Cowdray Avenue Address Colchester Essex CO1 1XX 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) 01206 769478 01206 578696 Mr Daramdeo Ramchurn Mr Daramdeo Ramchurn Care Home 3 Category(ies) of Learning disability (3) registration, with number of places 126 Cowdray Avenue DS0000017717.V310383.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd November 2005 Brief Description of the Service: The service consists of an extended and improved semi-detached house located within a mixed community of residential and commercial premises, and leisure facilities. The three-place care home provides individual bedroom accommodation within a domestic environment, furnished and equipped in a way commensurate with an ordinary domestic dwelling. The service is primarily a ‘home for life’ and persons living at the home are unlikely to move toward a less supported setting. The home is able to accommodate adults who require care and support, with less complex needs, that benefit from living within a family sized environment. 126 Cowdray Avenue DS0000017717.V310383.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The service continues to provide care for the two service users in a comfortable environment within a dwelling similar to that of an ordinary house. One service user was at home during the inspection and this person was spoken with as part of a case tracking approach. The registered person, Mr Ramchurn, was present during the inspection and Mrs Ramchurn was present for most of the inspection. No other staff were present. Care management arrangements have improved with a revised structure and the practice is developing in a positive way. Service users have choices and options in relation to their lifestyles and for the sample considered, this includes contact with family and friends. Some development is needed to ensure that social and emotional welfare is more comprehensively recorded within the plan of care. The one service user spoken with at the time of inspection expressed satisfaction with the home and of the support received. Issues related to illness and end of life issues remain in need of development. The arrangements for complaints and safeguarding adults are mainly satisfactory although staff remain in need of training. The Registered Person provided some improvement to this aspect of the home operation subsequent to the inspection visit. The environment was well maintained, clean and well furnished. Soma aspects to staffing need development although the staff turnover remains low and several are now undertaking some training, including shortly to commence on NVQ2. The manager needs to complete the Registered Managers Award, which is being progressed at the time of inspection. The quality assurance and monitoring will need to be developed to meet with requirements. There were no obvious health and safety issues noted. What the service does well: 126 Cowdray Avenue DS0000017717.V310383.R02.S.doc Version 5.2 Page 6 • The home environment continues to provide a homely setting, which is realistic in terms of achieving one of the service objectives of a homefrom-home. The service delivers a sound balance of ‘ordinary life’ principles within the home, being a mix of social, leisure and self-help tasks. • What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. 126 Cowdray Avenue DS0000017717.V310383.R02.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 126 Cowdray Avenue DS0000017717.V310383.R02.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1&2 • Service users who choose this service would benefit from an admission procedure that takes into account their choices, needs and wishes. This outcome group has been judged as ‘Good’ because there are more strengths than areas for improvement. There are no significant areas for improvement relating to the health and safety of people using the service or issues of poor management. The key NMS under this outcome heading are generally met but there may be some areas of improvement that we are confident the provider can manage. EVIDENCE: This three-place service had a vacancy at the time of the visit. The registered person was clear that the vacancy had not been filled, on the basis that referrals made to the service were for people who would not have the same interests, needs and aspirations of the current two service users. No recent referrals have developed as far as a formal visit. The service does have a procedure, which following the initial enquiry would be preceded by the referring agency care plan, a copy of which would be given to the registered person. Following this, if appropriate, an initial visit would be arranged and may be repeated several times leading toward an overnight or possibly a weekend stay. Current service users would be invited to express their views about how successful the stay had been. The process may then 126 Cowdray Avenue DS0000017717.V310383.R02.S.doc Version 5.2 Page 9 lead to a three month trial stay for all stakeholders involved to review the feasibility of a longer term arrangement being agreed. The three month period would form part of an ongoing assessment including all parties and would progress to a review at around the 3 month period where a decision would be made. At the time of this visit it was not possible to ‘test out’ the homes approach since no admissions have been made during the period since the previous inspection. However, the admission approach in terms of a practice and policy met with the requirements of National Minimum Standards. Service users are able to have a copy of the Statement of Purpose and will receive a Service Users Guide. It is recommended that the service users guide is further developed to improve the text toward an ‘easy read’ format. The document does currently have useful images to assist the text for service users. 126 Cowdray Avenue DS0000017717.V310383.R02.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 & 9 • Service users mainly benefit from knowing their needs and personal goals are reflected within their personal care plan. • Service users make decisions about their lives with support from staff. • Service users mainly benefit from support to take considered risks. This outcome group has been judged as ‘Good’ because there are more strengths than areas for improvement. There are no significant areas for improvement relating to the health and safety of people using the service or issues of poor management. The key NMS under this outcome heading are generally met but there may be some areas of improvement that we are confident the provider can manage. EVIDENCE: The care planning arrangements have been revised using an improved format. The practice associated with decision making has improved and risk assessment activity was evident. The context of the care management is relatively ‘scaled down’ in the sense that 126 Cowdray Avenue, although a registered care home, operates in a way that is reflective of an adult placement scheme. The care management is informal, flexible and reflects an ‘ordinary life’ model. From this perspective the care delivery continues to be 126 Cowdray Avenue DS0000017717.V310383.R02.S.doc Version 5.2 Page 11 chiefly styled upon an extended family approach. Clearly there was a positive relationship between the service user spoken with and the registered person who was in attendance at the time of this visit. The approach of the home was evidently suited to the service user spoken with. Of the two service users accommodated, one was not at home. The inspector was advised that this was due to the person attending a healthcare appointment with staff support followed by a community activity. The service user spoken with expressed satisfaction with their life at the home and whilst no formal organised external activities were being attended, for example a day centre, the service user expressed no wish to do so. The registered person, however, is planning to offer an opportunity for service users to attend an activity based session, probably two sessions per week initially, at a premises that the registered person owns and was formerly a registered care home. The intended activities were suggested as semioccupational, social and specific interest, for example the premises has a greenhouse and large garden for those interested in gardening. The content of the sampled care plan was well recorded and the decisions appropriate, together with associated assessment of risk where appropriate. The daily narrative remains limited in that this presents as a reflective diary on the part of carers rather than an opportunity to record events and information directly linked to the monitoring of care decisions. In terms of self-help tasks such as keeping the bedroom clean and tidy, clothes washing, preparation of food etc the person contributes at an informal level, and some of these activities are expressed within the plan of care, along with personal care objectives. It is recommended that social, emotional tasks identified as enabling the person to develop confidence and greater autonomy be comprehensively incorporated within a medium term plan in consultation with the service user. It is relevant to comment that the philosophy of this service is to provide a ‘home for life’ for as long as the individual wishes to remain there, and as such there has been be less emphasis on tasks and activities that could be recognised as those which enable a person to move toward a less dependent living setting. It is important however for individuals to experience success and achievement in their lives to promote confidence and self-esteem, and from this perspective the home is making some progress. Healthcare records were completed although these could be developed by ensuring improved continuity between the healthcare visit being made, the visit itself and post visit actions, if any. The service user confirmed that they have regular contact with family and friends and this is activity encouraged and facilitated by the home. 126 Cowdray Avenue DS0000017717.V310383.R02.S.doc Version 5.2 Page 12 No keyworker system is in operation and in the Inspectors opinion such an approach would not be necessary in view of the approach of the home and the very low numbers of persons accommodated. The level of individual knowledge and understanding of service users needs, wants and preferences is high. 126 Cowdray Avenue DS0000017717.V310383.R02.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 15, 16, & 17 • Service users do not yet fully benefit from opportunities for personal development. • Service users mainly benefit from age and peer appropriate activities. • Service users mainly benefit from opportunities to engage with the local community. • Service users have the benefit of support to retain contact with friends and family. • Service users mainly benefit from their rights and responsibilities being recognised. • Service users benefit from the catering provision of the home. This outcome group has been judged as ‘Good’ because there are more strengths than areas for improvement. There are no significant areas for improvement relating to the health and safety of people using the service or issues of poor management. The key NMS under this outcome heading are generally met but there may be some areas of improvement that we are confident the provider can manage. EVIDENCE: 126 Cowdray Avenue DS0000017717.V310383.R02.S.doc Version 5.2 Page 14 In discussion with the service user spoken with they expressed the things they were interested in and was able to show that the home supports the interests stated. All of the interests expressed were modest in terms of knitting, watching TV and going to the shops for example. The service user formerly attended a local authority day centre although it was very clear that this was not something the person would wish to do again. The person spoken was did not express a variety of interests to participate with local community resources although did confirm that friends were visited who live at the registered persons other registered home. It was difficult to ascertain if the person had made an informed choice about personal opportunities or whether there was further scope to identify options. It is recommended that the service user be assisted to keep a social and leisure diary or similar format to ‘map’ known interests and frequency of participation and perhaps identify other activities that the person may wish to try. The intended activity sessions at a separate venue, mentioned earlier in the report, may provide a good opportunity to explore these options. The service user confirmed that regular contact with and visits to members of their family on a regular basis are facilitated by the home. The service supports both service users to retain their own personal monies and this is accessed by a bank cash machine. The service user retains the receipt for the transaction. The registered person maintains appropriate receipts for payments received for weekly fees collected from the service user, however, it is recommended that improved methods of accounting and security are adopted on the basis that service users require support to use the bank ATM, which necessitates care staff having access to PIN codes. The practice adopted by the home is reflective of sound community access and ordinary life principles, which is positive, but the approach could potentially be subject to misuse. There was no suggestion that any impropriety was evident by any person employed at the home. The service user demonstrated a clear understanding of the value of cash personally held, and showed a keen interest in being ‘careful’ with spending. Records associated with food were adequate. Food stocks were good with fresh fruit evident. The service user stated that food provision was good. 126 Cowdray Avenue DS0000017717.V310383.R02.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 to 21 inclusive. • Service users benefit from the support provided by carers. • Service users mainly benefit from support with physical and emotional needs being met. • Service users mainly benefit from the homes approach to administration of prescribed medicines. • Service users do not yet benefit from the homes arrangements with the care associated with ageing and end of life. This outcome group has been judged as ‘Good’ because there are more strengths than areas for improvement. There are no significant areas for improvement relating to the health and safety of people using the service or issues of poor management. The key NMS under this outcome heading are generally met but there may be some areas of improvement that we are confident the provider can manage. EVIDENCE: Both service users are relatively able in communication and mobility, although, based upon the case tracked service user, the person does require support with personal care, social and emotional support. 126 Cowdray Avenue DS0000017717.V310383.R02.S.doc Version 5.2 Page 16 The plan of care does address matters of personal healthcare and there was evidence that healthcare professionals have been included as part of the strategy to meet stated care outcomes. The care plan together with outcomes of discussion with the service user demonstrated that physical wellbeing was being monitored, including periodical visits to primary healthcare professionals. It was difficult to fully and appropriately assess at the time of inspection whether social and emotional wellbeing was being met as this aspect was not fully developed within the plan and the service user did not appear confident to express their views, therefore the registered person is advised to ensure that the care planning arrangements have greater emphasis on this particular aspect of service users care. Service users who take prescribed medicines are encouraged to be as independent as possible, although current service users require all medicines to be administered by the home. The home will need to ensure that all medicines taken, including homely remedies are subject to written consent, which is maintained within the plan of care. Illness and end of life issues remain a weak area within the plan of care and should be addressed as appropriate within the care plan review. 126 Cowdray Avenue DS0000017717.V310383.R02.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): • • Service users mainly benefit from the homes approach to complaints. Service users do not fully benefit from the homes arrangements regarding safeguarding adults, chiefly regarding staff training. This outcome group has been judged as ‘Good’ because it has more strengths than areas for improvement. There are no significant areas for improvement relating to the health and safety of people using the service or issues of poor management. The key NMS under this outcome heading are generally met but there are some areas of improvement that the Inspector is confident the provider can manage. EVIDENCE: The home’s complaints procedure meets with National Minimum Standards and is available to service users. The registered person confirmed that copies are provided to families of service users and a summary is contained within the Service Users Guide. The Registered Person was advised at the time of the inspection visit that the document would benefit from review to ensure that all text is in ‘easy read’ format. Subsequent to the inspection, the Inspector was advised that an audio version of the complaint procedure has been made specifically for use by service users. This is a positive responsive action for the service and the registered person was advised to ensure that all service users who may require this version of the procedure receive a copy. The Inspector was advised that the home has not investigated any complaints during the period since the last inspection. CSCI have received no complaints about this service during the same period. 126 Cowdray Avenue DS0000017717.V310383.R02.S.doc Version 5.2 Page 18 The home has a copy of the current policy and procedures of the Essex Vulnerable Adults Committee and the Registered Person demonstrated a sound understanding of the practices and principles involved in the protection of vulnerable adults from abuse. The absence of staff training regarding protecting vulnerable adults has been a continued concern and the Registered Person has was urged at the time of inspection to ensure that staff awareness is concurrent with current practice and principles. See staffing section. Subsequent to the inspection visit, the Registered Person confirmed that two recently appointed carers have attended suitable training and that a further five staff are booked onto a local authority training day during November 2006. This is again a positive and developmental improvement. CSCI are unaware of any safeguarding adults referrals in connection with this service during the period since the previous inspection. 126 Cowdray Avenue DS0000017717.V310383.R02.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 • Service users benefit from living in a homely, clean and hygienic environment. This outcome group has been judged as ‘Good’ because there are more strengths than areas for improvement. There are no significant areas for improvement relating to the health and safety of people using the service or issues of poor management. EVIDENCE: The home is located in a mixed residential area including both commercial and leisure facilities. The house is an extended family style dwelling of domestic proportion. The rooms were homely, well furnished and clean. Both service users accommodated are ambulant and therefore no special equipment or adaptation are required. One bedroom was visited on this occasion and this was reflective of the occupant’s personality and was equipped with TV and audio equipment. Furnishings in the room were suitable. The décor within the rooms visited were suitable and well maintained. 126 Cowdray Avenue DS0000017717.V310383.R02.S.doc Version 5.2 Page 20 The service user spoken with stated they liked their own room and appeared comfortable within it. The laundry facility is of domestic proportion and adequate for the needs of two service users. The machine was capable of washing at temperatures necessary to disinfect, although this is not routinely necessary. There are no clinical waste issues to be managed. 126 Cowdray Avenue DS0000017717.V310383.R02.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 & 36 • Service users do not yet fully benefit from a competent and qualified workforce. • Service users benefit from the homes approach to recruitment. • Service users do not yet benefit from their needs being met by appropriately trained staff. • Service users mainly benefit from staff that are well supervised and supported. This outcome group has been judged as ‘Good’ because it has more strengths than areas for improvement. There are no significant areas for improvement relating to the health and safety of people using the service or issues of poor management. The key NMS under this outcome heading are generally met but there are some areas of improvement that the Inspector is confident the provider can manage. EVIDENCE: Records indicate that some staff had signed up to commence a course of study leading to National Vocational Qualification in care at level 2 (NVQ2). This is a positive development and will benefit the home and service users. Currently, over 50 of staff deployed in the home had an equivalent or higher qualification than NVQ level 2. The Registered Person and two other carers have a nursing qualification of the five overall carers deployed. 126 Cowdray Avenue DS0000017717.V310383.R02.S.doc Version 5.2 Page 22 From the sample taken, staff have attended some training such as food hygiene, however, it is important that carers supporting people with learning disabilities receive training in skills associated with this service user group. Typically this should include training linked to the Learning Disability Award Framework (LDAF). It is acknowledged, however, that in practice, access to this training has limited opportunity within the locality. The turnover of staff remains very low and this continues to provide valuable continuity. Whilst staff have continued in post for some time it is recommended that the registered person undertake the Skills for Care induction approach to ensure that any gaps in knowledge are met. Staff have begun to follow some distance learning related to reducing risks in food preparation and hygiene related topics. No staff have been recruited to the service since the last inspection and therefore the recruitment process was not tested as a recent sample. Files of staff who have previously been recruited were examined and found to comply with requirements. All necessary checks had been undertaken and Criminal Record Bureau (CRB) checks undertaken. Staff that have worked at the home for at least three years had a further check undertaken by the registered person, indicating a commitment to safeguarding adults. Whilst it is accepted that this service is a very small care home, it is important that carers providing support to service users are subject to National Minimum Standards. The Manager has undertaken some work on training and assessment profiles and this is a positive improvement. There is yet to be developed, a training and development profile for the service as a whole. Some progress on individual training and development assessment has now commenced. There was no information available that indicates the home has a dedicated staff training budget. A more structured approach to staff supervision has started and practice is now improved. It was not possible to ascertain the appropriate frequency of supervision yet and this will be again reviewed at the next Key Inspection but the evidence available was that a positive start has been made. 126 Cowdray Avenue DS0000017717.V310383.R02.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37 39 & 42 • Service users mainly benefit from a well run home. • Service users do not benefit from the home quality assurance and monitoring system. • Service users mainly benefit from the homes overall arrangements to safeguard their health and welfare. This outcome group has been judged as ‘Adequate’ because whilst there is some strength, there are areas of particular weakness that may require improvement through an improvement plan monitored by the Commission. Most key NMS under this outcome heading are almost met. The Inspector has judged that residents are safe in how the service delivers this outcome area. Potential risks to residents are being responded to by management. This includes quality assurance and monitoring. EVIDENCE: The registered person/manager has several years experience within the field of learning disability and is a former nurse specialising in this service user group. The CSCI is advised that the manager is currently following a course of learning leading to the Registered Managers Award (NVQ4 in both care and 126 Cowdray Avenue DS0000017717.V310383.R02.S.doc Version 5.2 Page 24 management). The Registered Person will advise CSCI when the course is complete and when confirmation of completion is available. The service requires development in its approach to quality assurance and monitoring to ensure that a continuous self-monitoring approach is adopted that uses an objective, consistently obtained and reviewed and verifiable method. This National Minimum Standard was rated 1 at the previous inspection and this current inspection was not able to identify any progress. On this basis this work will need to receive a higher priority. The registered person should refer to the NMS document for adults to review the requirements. There were no obvious health and safety hazards noted during this inspection. The home has arranged staff training in fire awareness and, as previously stated in this report, staff had commenced training on safe handling of food and food hygiene related matters. The registered person had a good understanding of the health and safety requirements relevant to the service. Various health and safety checks were reviewed including portable appliance, lighting, gas and fire safety checks. 126 Cowdray Avenue DS0000017717.V310383.R02.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 2 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 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 3 3 X 3 X LIFESTYLES Standard No Score 11 2 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 3 3 2 X 1 X X 3 X 126 Cowdray Avenue DS0000017717.V310383.R02.S.doc Version 5.2 Page 26 YES 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 YA11 Regulation 15 Requirement The Registered Person must ensure that opportunities to develop and maintain independent living skills are planned and recorded within the care management approach of the service. This is a repeat requirement previously to be completed by 30/01/06. Timescale for action 30/11/06 2 YA32 YA35 18(1)a 4 YA23 18a 5 YA39 24 The Registered Person must 30/11/06 ensure that staff have the necessary training and competencies to undertake the job. Each staff must have an individual training and development profile and training record. . This is a repeat requirement previously to be completed by 30/01/06. The registered person must 31/12/06 ensure that arrangements and resources within the home are suitable to safeguard vulnerable adults, including the training of staff. The Registered Person must 31/03/07 ensure that a method of quality assurance and quality monitoring is operated. This is a repeat DS0000017717.V310383.R02.S.doc Version 5.2 Page 27 126 Cowdray Avenue 6 YA37 9(2)(b)(i) requirement previously to be completed by 30/01/06. The registered manger must be qualified to NVQ level 4 in both care and management, or equivalent. 31/03/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard YA1 YA22 YA21 Good Practice Recommendations It is recommended that the Registered Person review the Service Users Guide and complaint procedure to improve the ‘easy read’ format of the document. It is recommended the Registered Person further develop care planning by introducing, as appropriate, matters associated with aging and illness to ascertaining wishes and feelings. The registered person is recommended to ensure that service users consent is obtained for the home to administer prescribed medicines. 3 YA20 126 Cowdray Avenue DS0000017717.V310383.R02.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ National Enquiry Line: 0845 015 0120 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 126 Cowdray Avenue DS0000017717.V310383.R02.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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