Care Home: 61 Somerset Road

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CARE HOME ADULTS 18-65 61 Somerset Road Barnet Hertfordshire EN5 1RF Lead Inspector Tom McKervey Unannounced Inspection 10th February 2009 10:15 61 Somerset Road DS0000010530.V374120.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 61 Somerset Road DS0000010530.V374120.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. 61 Somerset Road DS0000010530.V374120.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 61 Somerset Road Address Barnet Hertfordshire EN5 1RF 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) 020 8364 8222 F/P 020 8364 8222 ckearns@adepta.org.uk www.pentahact.org.uk PentaHact trading as Adepta Ms Rachel Gabriella Parker Ms Cheryl Adele Kearns Care Home 5 Category(ies) of Learning disability (5) registration, with number of places 61 Somerset Road DS0000010530.V374120.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Specific Service Users Two specific service users who are currently resident in the home and are over 65 years of age can reside in this home. This condition will need to be reviewed when one such service user vacates the home. Date of last inspection Brief Description of the Service: 61 Somerset Road is a care home for five adults of either gender, who have a learning disability. The home was opened in February 1991. The building is owned and maintained by Sanctuary Housing and is managed by PentaHact, which trades as Adepta. This is an organisation that manages several projects specialising in the provision of care for people who have special needs. The home is a detached two-storey building in a quiet residential area with shops and amenities close by. There is a gradient driveway leading up to the front door, and an area for off street parking to the front of the building. There is a large attractive garden at the rear of the premises. There are four bedrooms upstairs. One bedroom is located on the ground floor, along with an adapted shower, which is a suitable facility for someone who has difficulties with mobility. There is a shower and toilet on the ground floor and two bathrooms and toilet facilities on the first floor. On the first floor there is a bathroom/toilet and a sleep-in room for staff. There is a kitchen/diner, a large lounge and an activities room, a laundry room and an office, all of which are located on the ground floor. The range of fees for people living in the home is from £1,110 to £1,145 per week, depending on the level of their disability. The provider must make information available about the service, including inspection reports, to service users and other stakeholders. 61 Somerset Road DS0000010530.V374120.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 Stars. This means the people who use this service experience good quality outcomes This inspection was unannounced and was completed in five hours. The inspection included visiting all areas of the home and meeting the people who live in the home and speaking to them and the staff. Residents’ and staffs’ records and other documents relating to the running of the service were examined in detail. There were no visitors to the home during the inspection. Most of the people who live here are not able to converse but they can make their needs known in other ways that we were able to observe. The manager sent us valuable information in a document called an Annual Quality Assurance Audit, (AQAA). The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gives some numerical information about the service. The AQAA is referred to in appropriate sections of this report. What the service does well: There is good information about the service in easy to understand language and people are assessed before coming to the home, to make sure that their needs can be met. Although the majority of the residents are non-verbal, the staff have a good understanding of their needs and they communicate well with each other. Care plans are written in a way that are easy for staff to understand and residents are able to be involved in these plans. Each resident has a special carer, or key worker who takes particular responsibility for their care and support. The home provides good opportunities for people who live in the home to enjoy a stimulating and fulfilling lifestyle by making use of everyday opportunities in the community. This includes having a say in how the home is run, through regular meetings. The staff show a good knowledge and awareness about how to protect the residents from being abused, and people who live in the home are able to have an input when new staff are being recruited. The Adepta organisation carries out an audit each year of the people who use their services to find out their views and the company acts on the findings. 61 Somerset Road DS0000010530.V374120.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. 61 Somerset Road DS0000010530.V374120.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 61 Somerset Road DS0000010530.V374120.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 good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Potential users of this service can feel confidant that an assessment of their needs will be carried out to make sure that the home will be suitable for them and they will be provided with good information about what they can expect if they move in. EVIDENCE: There is a Statement of Purpose and a Service User Guide which accurately describe the service the home provides. The Service User Guide contains pictures to enable the people who live in the home to understand it. Five people are currently living in the home, one female and four males. There were no admissions to the home since the last inspection, and there are no vacancies at present. The AQAA states; “Any new admission would only be made after a thorough assessment of needs and in discussion with the person and in discussion with the people who already live in the home”. The acting manager stated that Barnet Local Authority who are responsible for placing the service users in the home, carried out a “Fair Pricing Review” in the past three months. The outcome of this review was awaited at the time of this inspection. 61 Somerset Road DS0000010530.V374120.R01.S.doc Version 5.2 Page 9 All but one of the people who live in the home, have done so for a number of years. One person who has mobility problems, occupies a downstairs bedroom with an adapted shower room adjacent. All the residents have tenancy agreements that include details about what is covered by the rent they pay. 61 Somerset Road DS0000010530.V374120.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, 8 & 9 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including observation and inspecting records. People who use this service can feel confident that the staff are aware about what each person needs to support them safely. This includes knowing what reasonable risks can be taken to ensure that the residents can live as full a life as possible. EVIDENCE: We examined two care plans in detail. These care plans are referred to as “Personal Development Plans”, (PDP). They are person-centred and written in the first person. Pictures are used to aid the resident’s understanding about what is written about them. Each person has a folder containing a very detailed history of their past, their likes and dislikes and their wishes for the future. They provide good guidance for staff about the residents’ personal care, activities of daily living, social and 61 Somerset Road DS0000010530.V374120.R01.S.doc Version 5.2 Page 11 leisure activities. The person’s cultural values and religious beliefs are also documented. Each resident is allocated a key-worker who is responsible for keeping the PDP up to date. This is done at monthly meetings between the resident and keyworker, which is recorded in the files. The PDP is also reviewed annually when other people are involved, for example, the home manager and staff from the person’s day centre. PDP’s include risk assessments about potential activities that they might do in the home or out in the community. There were clear guidelines for staff about managing challenging behaviours and how to minimise situations where they might arise. In the AQAA, the home tells us that; “Functional Assessments, Support Plans and Risk Assessments have all been reviewed or rewritten. This has been done in partnership with the people involved and with the intention of supporting personal control, choice, involvement and risk taking”. All of the residents have degrees of difficulty with verbal communication. However, we were satisfied by observation and discussion, that the staff were very knowledgeable about each person’s personality, needs and preferences and were aware of how individuals expressed their feelings and needs. This was demonstrated many times during the inspection; for example, by residents gesturing, taking staff by the arm, pointing to indicate that they wanted a drink, or by putting on a coat to show they wished to go out. 61 Somerset Road DS0000010530.V374120.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): All these standards were assessed. People who use this service experience good outcomes in this area. This judgement has been made using available evidence including observation and looking at case records. The people who live in the home are supported to partake in appropriate and stimulating activities at home and in the community. They are also supported to choose from a range of healthy and nutritious meals. EVIDENCE: On the day of the inspection, all the residents were at home with the exception of one resident who was at a day centre. We spoke to this person when they returned home in the afternoon. At various times of the day, people were being supported by staff on trips out in the home’s vehicle to shops and banks. The home has a leased car for taking people out. Some staff are authorised drivers of the home’s vehicle. We were told of a plan to share this responsibility with another nearby Adepta home to ensure more availability of drivers for both homes. Two residents also use public transport. 61 Somerset Road DS0000010530.V374120.R01.S.doc Version 5.2 Page 13 The acting manager stated that specific staff have been given special responsibility to coordinate individual activity programmes, a sample of which was shown to us at the inspection. Current activities include attendance at day centres and colleges for some residents. Other community activities include going to the pub and to various clubs. Some people also assist staff in daily chores for example; keeping their room tidy, washing up, shopping and doing their laundry. These are recorded in each person’s daily record. The home intends to improve in this area as follows; “Quality activities in – house, really spending fun time together engaging in communication with meaningful activities of individual choice; more books, games, art and stimulating creative activities”. Regular meetings with the residents are held, which are minuted. We noted that a sensory stimulation machine had been installed recently in the activities room, which provides a useful addition to the facilities in the home. Two people attend church on Sundays. Few residents have known relatives, but one resident has a monthly visit by an advocate from Mencap, which is funded through the resident’s Power of Attorney. There was evidence from the last inspection, that the home has obtained advocates for the other residents on an “as needs” basis.. All the residents had an individual holiday last year. A printed menu for the week was not available at the time of the inspection. We were told that the printer was not working and the menu was being printed in another home nearby. There was plenty of food in store, including fresh fruit Food in the fridge was in dated and correctly labelled, and temperatures were recorded daily. We were informed that residents choose various food items themselves when they do the shopping. During the inspection, we observed the residents having a meal at lunchtime which consisted of omelettes. The food was well cooked and attractively presented and the residents appeared to enjoy the meal. There were guidelines in the kitchen regarding food for a specific resident who is on a special diet. 61 Somerset Road DS0000010530.V374120.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): All these standards were assessed. People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home has responded positively to residents’ wishes about how they want to be addressed. People who live in the home can be confident that the staff respect their privacy and dignity and are sensitive to their changing needs. Staff make sure that residents have regular appointments with local health care services and that their medication is generally, administered safely. EVIDENCE: Each person who lives in the home has a care plan that provides details of how they like to be addressed and be supported by staff. Following a quality audit of all Adepta residents, they are identified as “People we support – (Psw’s)”,as their preferred mode of address. This is reflected in all records and case files. Some residents are becoming elderly and there is evidence in the care plans that staff give consideration to each individual’s changing health and other support needs. Care plans contain an assessment of peoples’ physical and mental health status which is recorded in “health action plans”. This gives a comprehensive medical history and record of immunisation etc. This document accompanies 61 Somerset Road DS0000010530.V374120.R01.S.doc Version 5.2 Page 15 the resident to health appointments to provide information for the health professional. We were informed that one resident continually pulls curtains off the windows and also enters other residents’ rooms and takes articles. We have made a requirement for a referral to a psychologist for assessment and advice about how to manage this challenging behaviour appropriately. Each person is registered with a G.P, and all residents are seen regularly by the Community Learning Disability Team, including the consultant, who reviews their medication. Monthly checks are made of the residents’ weights, which is another means of monitoring their health. There is evidence in the files that people are referred to appropriate professionals if they are unwell and everyone had the flu vaccine last winter.. If anyone needs to take medicine then the staff help him or her to do this. None of the people who live in the home are able to do this by themselves and the staff have written down why this is so on each of the care plans. The staff make sure that people take their medicines so that they can stay well. Appropriate checks were being made of the medication that was delivered to the home and any returns to the pharmacy of unused medication. The medication and the records of administration were examined. We noted that on one occasion, staff had not signed for one dose, which was pointed out to the manager to address. With this exception, we were satisfied that the procedures were being followed correctly and medication was safely stored. There is a record in each person’s file about their preferred end of life arrangements. 61 Somerset Road DS0000010530.V374120.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): Both these standards were assessed. People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The people who use the service can feel confident that the staff team at the home know what to do if there are complaints or concerns about abuse. The home has clear guidance for staff about the procedures to be followed in either of these circumstances. EVIDENCE: Since the last inspection, a new complaints form has been devised which is easier to understand and complete. The complaints procedure contains pictures which makes it easier for the residents to understand. At the last inspection, a recommendation was made for a method of tracking complaints has been implemented by the home. This enables complaints to be audited. No complaints have been made about the home in the past year and the residents appeared to be happy and well cared for. Two new staff were interviewed regarding their knowledge regarding abuse issues and how to report any concerns. We were satisfied that they were fully aware of their responsibilities in this regard. All staff have either attended training in this subject or are booked to undertake this training in the near future. Since the last inspection, an investigation was carried out into a serious incident following an allegation by a resident who complained that they had been mistreated by a member of staff at the home. 61 Somerset Road DS0000010530.V374120.R01.S.doc Version 5.2 Page 17 As a result of this investigation, the allegation was found to be substantiated and the staff was dismissed and referred to the protection of vulnerable adults register. 61 Somerset Road DS0000010530.V374120.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, 25, 26, 27, 28 & 30 People who use this service experience adequate outcomes in this area. This judgement has been made using available evidence including looking at all areas of the home. Although there have been significant improvements to the property recently, further improvements are needed to provide a more homely environment for the people who live there. EVIDENCE: The property is owned and maintained by Sanctuary Housing Association. All areas of the home, including residents’ bedrooms, were visited. . Residents’ bedrooms are decorated to their own taste. Generally, bedrooms were in good order and appropriately furnished. One person had a new bed and bedclothes. Since the last inspection, an opaque substance has been applied to a particular person’s bedroom window, which protects the resident’s privacy and dignity – (this person does not tolerate curtains on the windows). It was noted that the surface of one of the baths upstairs was chipped. This was noted at the last inspection, and a requirement is restated for this to be addressed. The seals around the bath in the other upstairs bathroom was worn 61 Somerset Road DS0000010530.V374120.R01.S.doc Version 5.2 Page 19 and stained and the décor was poor. This bathroom is in need of complete refurbishment. Requirements made at the last inspection regarding repairs in the kitchen area had been complied with. The laundry room was well equipped and the communal areas had appropriate furniture and fittings. However, as noted at the last inspection, the communal areas appear sparse and lack a homely feel. This was not helped by the lack of curtains on the large windows. We were informed that these were on order, as were wooden shutter blinds for elsewhere in the home. The surface of one of the baths upstairs was chipped and a new bath panel was needed. A requirement to address this issue is restated from the last inspection. The shower room/toilet on the ground floor was in a poor state. The floor covering was badly marked and there were pools of water on the floor which suggests that the drainage is poor. It is important for this to be addressed, as the person who uses this shower is unable to manage the stairs to the upstairs bathroom. A requirement is made for this to be addressed urgently. We examined the maintenance request book that is used for recording any faults. It was evident that the staff were diligent in reporting many of the above issues but the response from the landlord was very poor. There is no cleaner employed at the home. We were informed that a private company had been used to deep clean the home twice in the last few months, but daily cleaning is being done by the care staff. Given the dependency of this group of residents, the time needed to do cleaning detracts from the amount of time staff have to provide direct one to one care and we recommend that some cleaning hours are provided. However, the home was clean and tidy and there were no offensive odours. The large garden was well maintained and looked attractive 61 Somerset Road DS0000010530.V374120.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, 33, 35 & 36 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including speaking to staff and examining their records. People who live in the home can be confident that their carers are well trained about the best way to support them. The residents can also be confident that all staff are checked to make sure that they are not liable to harm them. EVIDENCE: Two staff are rostered to be on duty during the daytime, plus the manager, and at night, one member of staff sleeps in. The rota at the time of the inspection accurately identified the staff who were on duty that day. Staff to whom I spoke said that this level of staffing was usually appropriate to meet the needs of the current residents, but cleaning duties prevents them from providing more one-to-one care sessions. 50 of the staff have attained a National Vocational Qualification at level 2 and other staff are currently on this course. We were provided a spreadsheet which showed that staff had been trained on health and safety subjects that are mandatory for the safety and well being of the people who live in the home. Other courses include epilepsy, medication and protection of vulnerable adults. The company was currently booking staff on refresher training where appropriate. 61 Somerset Road DS0000010530.V374120.R01.S.doc Version 5.2 Page 21 Each member of staff has a training and development plan to ensure they keep updated about best practice. There were records showing that staff supervision takes place regularly and there is an annual appraisal. Staff stated that their one-to-one supervision was a positive experience which afforded an opportunity to discuss their work and performance in a constructive environment. Since the last inspection, one new staff had started working at the home. However, it was not possible to examine their records as these were held at the head office. There is an agreement between the Commission and Adepta, that recruitment records can be held at the head office and are scrutinised by the Commission’s performance relations manager. All the staff I spoke to, said they enjoyed their work and were committed to achieving the highest standard of care for the residents. 61 Somerset Road DS0000010530.V374120.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, 38, 39, 41 & 42 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The people who use the service can feel confident that they are living in a home that is run with their best interests at heart and that their views are sought. The service is well managed and staff are committed to provide a good quality of care. There is a good system for accounting for residents’ money and regular checking ensures the health and safety of residents and staff are protected. EVIDENCE: At the time of this inspection, the registered manager was on maternity leave. Until her return, there is an assistant manager who is supported by a manager from another Adepta home nearby. This manager is very experienced and 61 Somerset Road DS0000010530.V374120.R01.S.doc Version 5.2 Page 23 works in Somerset Road for two days per week and was present during this inspection. Staff who were spoken to, stated that they felt the home was well managed and there was a good team spirit. The AQAA informs us that; “The annual service review system has been updated and improved, Somerset Road’s last service review report was good and did show we were doing well. The review process for Somerset Road is ongoing in our development plan and we are due for a service review in March 09. A report will be sent to CSCI upon completing the service review”. This will include all the people who use the service and other stakeholders, all of whom will be invited to complete questionnaires. A senior manager carries out monthly visits to the home and makes a report. These reports are kept electronically on computer. Residents’ personal money is managed by a petty cash system with regular checks recorded by staff when money is withdrawn from the bank and put in individual pouches. A random inspection of two peoples’ records, found that the cash being held on behalf of the residents balanced with the records. We saw records showing that health and safety checks had been carried out within the last year for gas and electrical appliances and the water system had been tested for Legionella. The records showed that the fire alarms and emergency lighting systems are tested every week and there was evidence that fire drills are carried out regularly. There is a record of a comprehensive health and safety check of all areas of the home and there were certificates of safety for gas and electrical systems. Portable electric appliances had been tested within the past year. There is a valid certificate of employer’s liability insurance in place. 61 Somerset Road DS0000010530.V374120.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 3 2 3 3 3 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 2 25 3 26 3 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 X 35 3 36 3 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 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 3 3 3 X 3 3 X 61 Somerset Road DS0000010530.V374120.R01.S.doc Version 5.2 Page 25 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 YA19 Regulation 12(1)(b) Requirement A specific resident must be referred to the psychologist for assessment and advice about how to manage their challenging behaviour. The downstairs shower room must be refurbished and the problem with drainage addressed. The upstairs bathroom must be refurbished for the comfort of the people who live in the home. This requirement is restated from the last inspection. The previous timescale was 30/06/08 Timescale for action 31/03/09 2. YA27 23(2)(d) 31/03/09 3. YA27 23(2)(d) 31/03/09 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. YA33 Refer to Standard Good Practice Recommendations Consideration should be given to employing a cleaner in the home to allow staff to provide more care hours to the residents. 61 Somerset Road DS0000010530.V374120.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG 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 61 Somerset Road DS0000010530.V374120.R01.S.doc Version 5.2 Page 27 - 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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