Care Home: 75 Hightown Road

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What the care home does well The home offers a safe and comfortable environment that is suited to peoples` individual needs. People who use the service are supported to do the things they want to do and encouraged to take positive risks in order to maintain and increase their independence. Staff members work well in communicating with people who live in the home and finding ways to promote individual choices. The home operates a thorough system of checks on staff before they start work in order to protect people who use the service. Comments from a member of staff were: `I have never been happier in a job as I am here. We have a great staff team and support each other where needed. Also we get pride in knowing we give good supporting care to our service users`. Comments from a general practitioner included: `All the clients are well cared for, they appear happy. They are brought for medical attention promptly and appropriately`. What has improved since the last inspection? All the requirements from the previous inspection(s) have been met. We saw that care records are much better organised and reflect individuals` current needs and how the home is meeting these. Risk assessments have also been updated and are reviewed regularly. Staff members have received medication training and the environment has been improved to make it safer and better suited to the needs of the people who live there. Records including policies and procedures are being updated and the organisation is monitoring outcomes for people and taking action to address any shortfalls. An experienced manager has been recruited and is applying for registration. What the care home could do better: No areas for improvement were identified through this inspection. The organisation is continuing to provide management support to update the homes` records and the new acting manager has commenced regular formal supervision for staff. A drive to recruit more staff is underway. CARE HOME ADULTS 18-65 75 Hightown Road Ringwood Hampshire BH24 1NH Lead Inspector Laurie Stride Unannounced Inspection 26th February 2008 10:15 75 Hightown Road DS0000064991.V357009.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 75 Hightown Road DS0000064991.V357009.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. 75 Hightown Road DS0000064991.V357009.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 75 Hightown Road Address Ringwood Hampshire BH24 1NH 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) 01425 461269 www.c-i-c.co.uk. Community Integrated Care vacant Care Home 4 Category(ies) of Learning disability (4) registration, with number of places 75 Hightown Road DS0000064991.V357009.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6th September 2007 Brief Description of the Service: This home is registered to provide care and accommodation for four service users who are young adults and have a learning disability. The responsibility for managing this service is by Community Integrated Care (CIC). The property is leased from Hampshire Voluntary Housing. Accommodation is provided in a large family home, situated in a quiet residential area. It is close to local amenities, shops and public transport. People who use the service each have their own room on either ground or first floor and share two bathrooms. Access to the first floor can be gained by one flight of stairs. There is a large lounge, dining room, conservatory and kitchen/diner and an enclosed garden. The current fee is £1,031.06 per week. This information was obtained at the time of the inspection visit. Members of the public may wish to obtain more up-to-date information from the care home. 75 Hightown Road DS0000064991.V357009.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 was the homes’ second unannounced key inspection visit this year, which lasted approximately five hours, during which we, the commission, looked at how the home was performing in line with the key national minimum standards and also at the progress the service has made in meeting the requirements made at the previous inspection(s). We looked at samples of records and spoke with the new acting manager, who is applying for registration. We also spoke with two other members of the management team and two of the members of support staff on duty. We met two of the people who use the service, who were not able to communicate verbally with us due to their needs, however we observed staff interacting with people who live in the home in a respectful and friendly manner. Further information used in this report was obtained from the providers’ improvement plan and the previous inspection report. As part of this inspection, survey questionnaires were sent to a service user, relatives, staff, health and social care professionals. At the time of writing this report, comments had been received from two staff members and two general practitioners and their views are reflected in the main body of the report. What the service does well: The home offers a safe and comfortable environment that is suited to peoples’ individual needs. People who use the service are supported to do the things they want to do and encouraged to take positive risks in order to maintain and increase their independence. Staff members work well in communicating with people who live in the home and finding ways to promote individual choices. The home operates a thorough system of checks on staff before they start work in order to protect people who use the service. Comments from a member of staff were: ‘I have never been happier in a job as I am here. We have a great staff team and support each other where needed. Also we get pride in knowing we give good supporting care to our service users’. Comments from a general practitioner included: 75 Hightown Road DS0000064991.V357009.R01.S.doc Version 5.2 Page 6 ‘All the clients are well cared for, they appear happy. They are brought for medical attention promptly and appropriately’. 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. 75 Hightown Road DS0000064991.V357009.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 75 Hightown Road DS0000064991.V357009.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): Standard 2 People who use the service experience good outcomes in this area. We have made this judgement using available evidence including a visit to this service. Systems are in place to assess the needs of individuals before they move into the home and to keep these under review. EVIDENCE: The home provides a pictorial version of the Statement of Purpose and Service User Guide, to assist people who may wish to use the service to understand what the service can offer. The acting manager confirmed that there have been no new admissions since the last inspection. We looked at samples of the care records for the four people who currently use the service. Each of the individuals’ had recently had a review of their support needs and goals, which had been attended by their care manager and correspondence showed that further reviews were booked in for three months time. Actions arising from the reviews were being incorporated into individual care plans, for example planned activities, financial and healthcare matters. Each file contained a copy of the licence agreement. 75 Hightown Road DS0000064991.V357009.R01.S.doc Version 5.2 Page 9 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): Standards 6, 7 & 9 People who use the service experience good outcomes in this area. We have made this judgement using available evidence including a visit to this service. The home supports people who use the service to make decisions about their lives and explores new ways to do this. Good care planning and risk assessment systems are now in place to record and monitor how the home is meeting individuals’ needs and aspirations. EVIDENCE: The previous two reports had identified requirements for the home to improve on care planning and risk assessments, which have now been met. Since the previous inspection, a lot of work has been done to make assessment, care planning and recording better organised and we observed further ongoing work in progress during our visit. The current care plans we saw are in a person centred format and included assessments about, for example, communication, personal hygiene, awareness 75 Hightown Road DS0000064991.V357009.R01.S.doc Version 5.2 Page 10 and safety, working and recreation, independent travel and relationships. These included clear guidelines for staff giving support, who sign to say they have read and understood the plans. We talked with two staff members individually, who both demonstrated a good knowledge of individual service users personalities and needs. Both gave accounts of how they would support individuals that were consistent with the persons’ care plan and demonstrated how they would promote the individuals’ choice and dignity. The staff members said they felt that care plans are now more streamlined and improved, making it easier to find and record information. Two staff members who completed survey questionnaires indicated that they are always given up to date information about the needs of the people they support. Through looking at the records and talking with staff, we saw that communication aids such as picture cards are used to enable individuals to participate in their support planning. There are weekly meetings between individuals and their key workers and a record of one of these showed how a decision had been made regarding the individuals’ choice of a holiday. The meeting had also been used to explain to the individual about recent management changes in the home. Information from these meetings is carried forward to a monthly review with the home’s manager, so that outcomes are being monitored. The care plan for one service user showed that the home is involving the individuals’ relatives more and had provided them with information about person-centred care planning. The recent review had also identified horse riding as a goal and this was being explored by the individual with support from their key-worker. A risk assessment had already been put in place and the outcome will be looked at during the next overall review in three months time. Risk assessments for each individual had been reviewed and updated and were signed by the care manager and the area service manager. These included moving and handling and mobility assessments, environmental assessments and those covering various daily activities. Comments received from two general practitioners who have contact with the home, confirmed that the service always respects individuals’ privacy and dignity. During our visit we observed staff interacting with people who use the service in a friendly and respectful manner. 75 Hightown Road DS0000064991.V357009.R01.S.doc Version 5.2 Page 11 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): Standards 12, 13, 14, 15, 16 & 17 People who use the service experience good outcomes in this area. We have made this judgement using available evidence including a visit to this service. The service promotes a variety of activities for individuals and opportunities to maintain relationships with family and friends. People who use the service are provided with a balanced and healthy diet that suits their assessed needs and preferences. EVIDENCE: The previous inspection report had identified good outcomes in this area for people who use the service. Throughout our visit we observed individuals coming and going supported by members of staff. There is an activities board in the hallway, showing what individuals take part in on a regular basis. For example, one person likes to attend a luncheon club and coffee mornings, for which additional staff are available, two others enjoy swimming and one person also goes dancing and visits the library. There are photographs of other 75 Hightown Road DS0000064991.V357009.R01.S.doc Version 5.2 Page 12 activities that have taken place, such as Halloween and Christmas parties and outings. The acting manager said that a trip to the seaside had taken place the previous week. A ‘meet the manager’ party had been arranged for relatives to attend in March. People who use the service also attend day service during the week and care plans contained individual pictorial schedules. Care plans contained information about the things that each person enjoys doing and we saw daily evaluation records completed by staff, showing how the home supports people to do these things, for example going for a picnic and watching animals, trips to the shops and helping in the kitchen. The records further demonstrated that individuals are enabled to access the community and engage in chosen activities. We discussed some of the evaluation records with the new acting manager, who agreed that these could give a clearer indication of how individuals make choices on a daily basis. The records of key worker meetings with individuals already show how longer term decisions are made, such as choosing a holiday. Each person had planned an individual holiday for this year. The home has the use of a vehicle but also encourages individuals to use public transport so that they remain part of the community. People are supported to keep in touch with friends and relatives Routine tasks had been broken down in care plans to assist staff to involve individuals with things such as cooking and dealing with food. Food menus were available in the kitchen, including ‘healthy options’ for two people who were assessed as requiring support to monitor their food intake. Weight charts were being recorded regularly and individual choice regarding the menu is promoted. One person kept her own supply of tea bags in the kitchen. 75 Hightown Road DS0000064991.V357009.R01.S.doc Version 5.2 Page 13 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): Standards 18, 19 & 20 People who use the service experience good outcomes in this area. We have made this judgement using available evidence including a visit to this service. The health care and personal support people receive is based on their individual needs. Improvements in health care monitoring and recording and medication training promote the safety and welfare of people who use the service. EVIDENCE: Care plan reviews showed that the home supports people who use the service to access health care services. For example, one person had been referred to a speech and language therapist. Appointments with other professionals such as foot care specialists, dentists and doctors are recorded as part of health action plans, which form part of the care plan. The issue, diagnosis and outcome for each appointment is recorded and some of these had been written in by the doctor, which further ensures that the information passed between staff is correct. 75 Hightown Road DS0000064991.V357009.R01.S.doc Version 5.2 Page 14 Comments received from two general practitioners who have contact with the home, confirmed that the home always seeks advice and acts upon it to manage and improve individuals’ health care needs. It was also indicated that staff members have the right skills and experience to support people effectively. The two members of staff we spoke to during our visit demonstrated a good understanding of individual’s health care and support needs and confirmed that they have received relevant training and guidance to meet these needs. The previous report had identified a requirement for the home to ensure that the healthcare needs of individuals are reflected in their care plans and that these needs are reassessed and reviewed regularly. This requirement has been met. During this visit we saw updated individual assessments and care plans were in place for pressure care, continence, mobility and monitoring peoples’ nutrition and weight. These give clear guidance for staff supporting the individuals, including training and advice from relevant professionals, for example an Occupational Therapist. Specialist equipment such as handling belts had been obtained in line with the assessed need. A multi-disciplinary response to one person’s mobility needs had been recorded, including the relevant care manager and an advocate and a date for further review had been set. The previous report had also identified a requirement regarding training for staff in medication. This requirement has also been met. Staff had received training from a pharmacist and also undertaken competency assessments, which are part of the induction and are re-taken every six months. The new acting manager has reviewed the local medication policy and procedure and staff had signed to say they had read and understand them. Certificates for the training were seen in staff members’ files and staff we spoke to demonstrated their knowledge of the homes’ procedures for the safe administration of medication. Information about individuals’ medication is recorded in their care plans including what the medication is for and any possible side effects. We looked at a sample of the medication records for two people who use the service and these had been completed in line with the procedures. Two individuals are prescribed ‘as required’ medication and the procedure is that staff will telephone the GP first before giving the medication. The medication is very rarely used and the acting manager confirmed that the use of the protocol would be monitored and recorded. 75 Hightown Road DS0000064991.V357009.R01.S.doc Version 5.2 Page 15 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): Standards 22 & 23 People who use the service experience good outcomes in this area. We have made this judgement using available evidence including a visit to this service. Suitable complaints and safeguarding procedures are in place, underpinned by improved record keeping and staff who have the right knowledge and skills. EVIDENCE: The previous report had identified a requirement that there must be a process to monitor complaints and subsequent actions taken by the home. The acting manager reported that the home has not received any complaints since the previous inspection and there have been no safeguarding issues. We have also not received any concerns or complaints about the home. The acting manager confirmed that any reported concerns or complaints would be recorded with details of the action taken and outcome and a copy of the record would be held on site. The area service manager conducts regulation 26 visits and there is a section in the report for recording complaints. The requirement has therefore not been repeated. We saw that the home has improved the format of the complaints procedure to make it more accessible for people who use the service. The procedure is available in a picture format and also on audio / compact disc. The acting manager and the two staff we spoke to felt that they would be able to identify if a service user had concerns or was dissatisfied, through monitoring of changes in the persons’ behaviour and mood, which are recorded in the daily 75 Hightown Road DS0000064991.V357009.R01.S.doc Version 5.2 Page 16 evaluation log and minutes of key worker meetings. Survey questionnaires returned by two staff members indicated that they know what to do if someone has concerns about the home. One of the service users has an independent advocate and the involvement of another persons’ relatives has increased. Staff we spoke to confirmed they have had training in relation to safeguarding people and demonstrated their understanding of the reporting procedures. The home had notified us of an incident affecting the well being of one service user and we saw records of a multi-disciplinary response to reviewing this person’s support needs. The home supports people to manage their personal money and we saw that records of expenditure and receipts are kept. The acting manager said that these records and the balance are checked and signed for on a daily basis as part of the staff handover. Service users finances are monitored as part of the review process involving their care manager. 75 Hightown Road DS0000064991.V357009.R01.S.doc Version 5.2 Page 17 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): Standards 24 & 30 People who use the service experience good outcomes in this area. We have made this judgement using available evidence including a visit to this service. People who use the service benefit from the improvements that have been made to make the home more safe, comfortable and suited to individual needs. EVIDENCE: The previous inspection report had identified a requirement that the internal and external premises must be kept in a clean and tidy state and be accessible to people who use the service. The providers improvement plan had stated that the patio had since then been made safe and level outside the fire door, bags of garden rubbish and the greenhouse had been removed and new flooring was to be fitted in the dining room and front room. During our visit we saw that all of this had been completed, therefore the requirement has been met. 75 Hightown Road DS0000064991.V357009.R01.S.doc Version 5.2 Page 18 We undertook a tour of the communal areas and also saw one of the service users’ bedrooms. The overall impression was one of a clean, airy, bright and homely environment. In addition to the new flooring, the hallway, lounge and dining areas had been re-decorated and pictures and sensory lights had been put up. Staff had also put up picture boards in the hallway, showing photographs of people who use the service on holidays and engaged in activities. Staff said that this has particularly improved the home for one individual who likes to sit in the hallway area and has a chair there so they can watch what goes on in the house. Another of the people who live in the home was said to be using the lounge now that the improvements had been completed. The downstairs bathroom had recently been painted and decorated and is fitted with a specialist bath to assist people with mobility issues. Another bathroom upstairs is mainly used by one of the people who live in the home and we saw that water temperatures are checked and recorded regularly. There are two office rooms upstairs for care staff and managers to use. The kitchen had also recently been decorated and we observed one of the people who use the service accessing this area freely. The home has a suitably equipped laundry room and we saw that protective items such as gloves are available for staff and that cleaning materials were safely stored when not in use. 75 Hightown Road DS0000064991.V357009.R01.S.doc Version 5.2 Page 19 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): Standards 32, 34, 35 & 36 People who use the service experience good outcomes in this area. We have made this judgement using available evidence including a visit to this service. People who use the service are protected by robust recruitment practices and supported by suitably trained staff. Regular supervision of all staff will further ensure that good care practices are maintained and staff members are supported in meeting peoples’ needs. EVIDENCE: The home has a mix of both male and female staff and there are currently two vacancies for full time staff, for which the new acting manager said applications have been received. The rota showed two staff on duty on each of the early and late shifts and one member of staff awake at night. There is also some additional staff support from another organisation in relation to specific activities that individuals do. Four of the shifts for this week and two shifts during the next week were covered by a member of agency staff, who the acting manager said is used regularly to promote continuity of care for people who use the service. The acting manager said she felt that the current staffing levels meet peoples’ needs and we saw people receiving appropriate individual 75 Hightown Road DS0000064991.V357009.R01.S.doc Version 5.2 Page 20 support during our visit. Survey questionnaires returned by two staff members indicated that they thought there is usually enough staff to meet individual needs. One commented ‘We have been through quite a rough time so far as staffing issues are concerned. Relying on relief staff a lot of the time. A recruiting campaign is now underway to address this.’ Staff members we spoke to demonstrated good knowledge of peoples’ individual needs and the agreed ways of working with them. The acting manager reported that four staff members are qualified to NVQ level 2 or above and another member of staff is working toward being qualified. There are two full time and one part-time staff members currently without such a qualification. One member of staff we spoke to said they hoped to start an NVQ course in April this year. Staff who returned questionnaires said they feel that they have the right support, experience and knowledge to meet the different needs of people who use the service. The previous report showed that the service carries out thorough staff recruitment checks and we confirmed this through inspecting a sample of staff files. The two staff members’ files contained evidence of Protection of Vulnerable Adults (POVA) and Criminal Records Bureau (CRB) checks, two written references, completed application forms with employment histories. These also included information about staff induction, probation periods and supervision. There were some long intervals between supervisions for an individual whose records we saw, for example only three supervision meetings between July 2007 and February 2008 inclusive. This reflects the number of management changes there has been in the home in recent months. We discussed this with the new acting manager, who had already written a supervision schedule and had commenced meetings with individual staff members. The sample of staff records showed that training is provided to assist staff to meet the needs of people using the service and to comply with safe working standards. Staff members have training in moving and handling, first aid, food hygiene, fire safety and had completed the pharmacy training in medication and receive regular medication competency assessments. We also saw evidence that recent training in pressure care and continence awareness had been provided. The two staff members we spoke with said they thought the training was useful and one mentioned other training they had undertaken with the organisation around involving people who use the service. Staff also reported that they had completed safeguarding people and how to deal with 75 Hightown Road DS0000064991.V357009.R01.S.doc Version 5.2 Page 21 complaints training. The acting manager said that staff records were still in the process of being updated and put on the computer system. Survey questionnaires returned by two staff members indicated that their induction covered everything they needed to know to do the job when they started. They also confirmed that they are given training which is relevant to their role, helps them to understand and meet the individual needs of service users, and keeps them up to date with new ways of working. A survey questionnaire returned by a general practitioner, who has contact with the service, indicated that staff always have the right skills and experience to support individuals’ social and health care needs. 75 Hightown Road DS0000064991.V357009.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): Standards 37, 39, 40, 41 & 42 People who use the service experience good outcomes in this area. We have made this judgement using available evidence including a visit to this service. Improvements in management practices promote the wellbeing and best interests of the people who use the service. EVIDENCE: We met the new acting manager who has been in post since 04/02/08 and is on her induction, supported by the temporary acting manager who will remain in post until 17/03/08. Support is also provided by weekly visits by the area service manager. A training officer was also on site at the time of our visit, who was assisting in the work of reviewing and updating the homes’ records. The new acting manager, who has previous relevant experience, is currently in the process of applying for registration and is undertaking training provided by 75 Hightown Road DS0000064991.V357009.R01.S.doc Version 5.2 Page 23 the organisation. There are management meetings every six weeks, which enable managers of homes to discuss issues and receive support. Through discussion with the three managers present on the day of our visit and the findings detailed in this report, it was evident that the organisation has been providing the management support to bring about the required improvements. The new acting manager is currently supernumerary on the rota and reported that the time allocated for management duties in the home has been increased by fifteen hours. This means that after the induction period, the manager will have three days a week for management duties and two days allocated to care duties. The new acting manager said she will be able to chose which days she works as a carer, so that additional opportunities to complete management tasks may be available, for example when service users are out. This will help to ensure that the current level of improvement is consolidated and sustained. We saw improvements had been made in the assessment, monitoring and review of individual needs, care and support planning, risk assessment and record keeping, medication training for staff, the environment, policies and procedures and safe working practices. Previous requirements have all been met and no new requirements were identified as a result of this visit. There is a corporate service user quality assurance survey and the temporary acting manager said that a relatives survey had recently been distributed. The home has regular key worker meetings where issues affecting service users can be discussed. Recent and ongoing reviews involving each service user, their care manager, invited relatives, advocate and staff key workers, provide opportunities for all to give their views about how the service is performing. The area service manager conducts regulation 26 visits and writes a report on these, which we saw are kept in the home. The reports identify any follow up actions that the service needs to take. Chemicals used for cleaning were stored securely when not in use and fire doors were either shut or had automatic closers. The new acting manager had reviewed some of the homes’ policies and procedures, for example fire safety and medication and was meeting with the area manager to discuss these. We also saw that new hazard risk assessments were in place, covering infection control and the general environment. Infection control procedures, such as waste disposal contracts and individual laundry bags were also in place. The homes’ health and safety file contained records of regular checks on, for 75 Hightown Road DS0000064991.V357009.R01.S.doc Version 5.2 Page 24 example, water temperatures, cleaning equipment, homes vehicle and fire safety systems. 75 Hightown Road DS0000064991.V357009.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 X 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 3 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 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 2 X 3 3 3 3 X 75 Hightown Road DS0000064991.V357009.R01.S.doc Version 5.2 Page 26 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action 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 75 Hightown Road DS0000064991.V357009.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. 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