Care Home: Appleton House

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What the care home does well From talking with residents and from the comments received it was clear that residents were happy living at the home and that staff and residents got on well together. Care plans were person centred and provided good information for staff on the support that was required and informed staff how residents wanted this support to be given. Residents are given every opportunity to make their own decisions and they are offered choice in all aspects of their life. Staff are on hand to offer support when required, residents are consulted regularly and have the support of a key team member who hold weekly one to one support sessions with them.The residents are supported to participate in appropriate activities and are encouraged and supported to obtain suitable employment. Staff provides care and support to enable residents to live an independent lifestyle as much as possible. The routines in the home promote residents independence and staff provide support for residents with budgeting and cooking to help develop independent living skills. Residents are encouraged and supported to take responsibility for their own medication and risk assessments are in place to support this process. The home has a dedicated and stable staff team and staff have been supported to obtain recognised qualifications and over 90% of the care staff employed by the home has achieved National Vocational Qualifications. They are committed to their role and work well together as a team. The home has an effective training programme and staff said that the home provides training in all areas and this enables them to carry out their job effectively. What has improved since the last inspection? Since the last inspection the manager has consulted the pharmacist for guidance on how those residents who self medicate could be better supported with regard to dispensing their medication and appropriate procedures are now in place. Risk assessments have been reviewed and amended to minimise risks of injury or harm to residents when using the kitchen. A care co-ordinator has been employed and she is working with key teams and residents to get residents more involved and motivated to participate in activities both in and outside the home and she has supported residents in identifying personal goals and aspirations. CARE HOME ADULTS 18-65 Appleton House 26 Chafen Road Bitterne Bitterne Manor Southampton Hampshire SO18 1BB Lead Inspector Mick Gough Unannounced Inspection 4th June 2008 10:15 Appleton House DS0000061570.V365192.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 Appleton House DS0000061570.V365192.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. Appleton House DS0000061570.V365192.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Appleton House Address 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) 26 Chafen Road Bitterne Bitterne Manor Southampton Hampshire SO18 1BB 02380 839388 manager.appleton@truecare.co.uk Truecare Group Ltd Miss Tracy Marie Creagh Care Home 7 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (7) of places Appleton House DS0000061570.V365192.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. One Service user in the LD category, admitted on the 9/1/07, may be accommodated. 7th June 2006 Date of last inspection Brief Description of the Service: 26 Chafen Road also known as Appleton House is situated in the Bitterne area of Southampton. The home is registered for seven service users with mental health needs. The large detached home consists of seven individual flats, which contain en-suite facilities and basic kitchen areas. The home also provides a separate service user kitchen and communal lounge and dining area. To the front of the property is a small garden and to the rear is a large landscaped garden. The home is situated close to local shops and amenities and a short car or bus journey away from Southampton city centre. At the time of this report fees at the home ranged between £1,065 to £2,633 per week but this is dependant on the needs of the service user and the type of support required. Further information regarding fees can be obtained from the home. Appleton House DS0000061570.V365192.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 3 star. This means the people who use this service experience Excellent quality outcomes. This report details the evaluation of the quality of the service provided at Appleton House and takes into account the accumulated evidence of the activity at the home since the last inspection, which was carried out in June 2006. The inspection took into account; the previous key inspection report and information from what other people have told us about the service. Comment cards were sent out to staff and residents at the home, however at the time of writing this report no responses have been received. Included in the inspection was an unannounced site visit to the home, which took place on the 4 June 2008. Evidence for this report was obtained from reading and inspecting records, touring the home and from observing the interaction between staff and users of the service. It was also possible to speak with 3 people who live in the home, 3 members of staff and the homes manager who assisted the inspector throughout the visit. The home is registered to provide support for 7 residents and at the time of the inspection there were 5 people living at the home. What the service does well: From talking with residents and from the comments received it was clear that residents were happy living at the home and that staff and residents got on well together. Care plans were person centred and provided good information for staff on the support that was required and informed staff how residents wanted this support to be given. Residents are given every opportunity to make their own decisions and they are offered choice in all aspects of their life. Staff are on hand to offer support when required, residents are consulted regularly and have the support of a key team member who hold weekly one to one support sessions with them. Appleton House DS0000061570.V365192.R01.S.doc Version 5.2 Page 6 The residents are supported to participate in appropriate activities and are encouraged and supported to obtain suitable employment. Staff provides care and support to enable residents to live an independent lifestyle as much as possible. The routines in the home promote residents independence and staff provide support for residents with budgeting and cooking to help develop independent living skills. Residents are encouraged and supported to take responsibility for their own medication and risk assessments are in place to support this process. The home has a dedicated and stable staff team and staff have been supported to obtain recognised qualifications and over 90 of the care staff employed by the home has achieved National Vocational Qualifications. They are committed to their role and work well together as a team. The home has an effective training programme and staff said that the home provides training in all areas and this enables them to carry out their job effectively. What has improved since the last inspection? What they could do better: There were no requirements or recommendations made as a result of this visit however, the home’s medication cabinet was checked and this was suitable for its current purpose as the home does not currently hold any controlled drugs. However the law concerning the storage of controlled drugs has recently changed and the home was reminded that should there be a need for any controlled drugs to be held in the home, they must be stored in a proper Controlled Drugs Cupboard. A proper Controlled Drugs cupboard is one, which meets the standard set in the Misuse of Drugs (Safe Custody) Regulations 1973. Suppliers of CD cabinets can confirm that a cupboard meets the legal requirements. Appleton House DS0000061570.V365192.R01.S.doc Version 5.2 Page 7 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. Appleton House DS0000061570.V365192.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Appleton House DS0000061570.V365192.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective users of the service can be confidents that their needs would be fully assessed before they move into the home. EVIDENCE: The home’s completed AQAA stated that the home had a policy and procedure for any admissions to the home and that admissions would only be made after a full assessment of needs. Assessments were seen for 2 people who use the service and one of these had recently moved into the home in April 2008. The registered providers have a referrals team who carry out an initial assessment and this assessment is then passed to the manager who will visit the potential new user of the service along with their care manager to see if the home can meet their individual needs. The last person to move into the home did so from a long-term placement and we saw that there was a good transitional procedure. There are reviews carried out on placement at 6 weekly, 3 monthly and 6 monthly intervals to ensure that the placement is suitable for all concerned. Appleton House DS0000061570.V365192.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The assessed needs and personal goals of residents are reflected in an individual plan of care and people who use the service are supported to make decision about their lives with assistance given by staff. Residents are supported to take responsible risks and this allows them to live an independent lifestyle as much as possible. EVIDENCE: Care and support plans were seen for 2 residents and these were clear and easy to follow and gave clear information on individual abilities, problems and needs, aim of care and the method of care delivery. Plans were person centred and gave staff the information they needed and informed them how individuals liked to be supported and when this support should be given. We were told that should there be a need, outside agencies are contacted to support the residents and they provide input into the care plan. The AQAA stated that care plans were agreed with residents and were reviewed and updated monthly, this was confirmed by recording in the care plans. There was evidence of monthly reviews by care staff and also six Appleton House DS0000061570.V365192.R01.S.doc Version 5.2 Page 11 monthly reviews with residents, relatives and support workers who are invited to attend. The home records at the end of each shift what support had been given and how the resident had been. Residents spoken with were full of praise for the support they receive from care staff and were aware of their care plan and its contents and those plans seen had been signed by residents. Residents are supported to make decisions about their day to day lives and staff were observed interacting with residents and taking their views into account. Residents spoken to said that staff always asked them what they wanted to do and said that they could make their own decisions and staff would support them. All residents have keys to their rooms and are free to come and go independently, there are regular one to one support sessions and monthly residents meeting are held. There was information in care notes, which showed that residents had been offered choices and also detailed the choices made. One resident has requested to move to another room and the home is looking to enable him to do this. Care plans looked at contained risk assessments and these gave details of the assumed risk, the level of risk and also details of the risk. They detailed control measures to minimise the risk and they gave staff good information on any support that was required. Residents spoken to said that they felt safe and well supported by staff. Appleton House DS0000061570.V365192.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are supported to take part in appropriate activities and they access the local community on a regular basis. They have opportunities for personal development and are encouraged and supported to be part of the local community. The homes visiting policy supports residents to maintain family links and friendships both inside and outside the home and their rights are respected. Residents are offered support to plan their own menu and to buy and cook their own food. EVIDENCE: One of the residents at the home is employed at St Mary’s stadium and another carries out voluntary work. The home is also supporting one resident who is looking to find some form of employment. The home has employed a day care co-ordinator and she regularly meets with residents to establish a weekly schedule of events, these include food shopping, cooking, cleaning rooms, laundry, accessing transport, budgeting, Appleton House DS0000061570.V365192.R01.S.doc Version 5.2 Page 13 leisure, education, employment and planning to move to independent living. The home has transport available for residents and has also supported residents to obtain bus passes for those who need/want them. Community access is recorded in care plans and shows the frequency of time out of the home and location of the trip. There are information folders in the communal areas of the home to show residents whats on in the local area. We spoke with the day care co-ordinator who told us that residents are slowly getting more involved in planning activities and that she was well supported by the other staff at the home. She is planning an overnight camping trip and residents told us that they are looking forward to this. The care co-ordinator has supported one resident to fly up to Glasgow in preparation for a trip abroad. Residents are able to access the local community independently and they regularly go out shopping. Staff support is available for any residents who does not have the confidence to go out on their own. The home has a clear visiting policy and visitors are always welcome and we were informed that staff would respect residents wishes on who they wish or do not wish to see. Daily routines in the home promote residents independence as much as possible and they are encouraged to participate in day to day routines. During the visit staff were observed interacting with residents and they got on well together, staff used residents preferred form of address and those residents who we spoke with made it clear that they was very happy at the home and said that routines in the home were relaxed and they could be involved as much or as little as they want. Mail is given to residents unopened and staff support is available if required. All residents are able to have a key to the home and they have access to all areas of the home and there were no restrictions they are free to come and go as they wish. Menus at the home are made up with each individual and residents are able to purchase their own food for the week from their own individual budget. The kitchen has 3 separate cooking areas where residents can prepare their own meals. Each resident has a fridge in their room where they are able to keep their own shopping and staff will support residents with budgeting, shopping and cooking. Residents are able to make their own drinks and snacks and are encouraged to eat healthily. The manager told us that one meal each week is cooked by the staff with residents support and residents are encouraged to eat this meal together at the dining table, however they can eat elsewhere if they wish. Residents spoken to told us that they liked the flexibility to buy and cook their own food and this gave them independence. Appleton House DS0000061570.V365192.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health, personal and social care needs of residents are set out in an individual plan of care and residents have access to all relevant health care professionals and their health care needs are met. Residents are protected by the homes policies and procedures regarding medication. EVIDENCE: Care plans had information on the personal care needs of individuals and this was a mainly verbal prompt. Residents spoken to said that their care needs were met by the home and that they could see health care professionals in private. When we spoke to the manager and staff they were very aware of the residents health and emotional care needs and know the residents well. Residents are all registered at a local GP surgery, however may have different GP’s. Dental checks are obtained through local NHS dentists and sight tests are obtained from local opticians. The home has support from local mental health and learning disability teams and other healthcare professionals are available through GP referral. Resident’s folders contained medical notes and these provided evidence that residents health needs are monitored and met. Appleton House DS0000061570.V365192.R01.S.doc Version 5.2 Page 15 The home has a clear up to date medication policy and procedure and all residents at the home are supported to self medicate if they are able. Medication is provided from a local pharmacy and repeat prescriptions are picked by the pharmacist direct from the GP surgery. There were clear risk assessments in place for those residents who self medicate and clear records were kept of all medication administered. All staff have received training with regard to medication and the local pharmacist carries out regular visits to the home. The home’s medication cabinet was checked and this was suitable for its current purpose and the home does not currently hold any controlled drugs. The law concerning the storage of controlled drugs has recently changed and the home was reminded that should there be a need for any controlled drugs to be held at the home, they must be stored in a proper Controlled Drugs Cupboard. A proper Controlled Drugs cupboard is one, which meets the standard set in the Misuse of Drugs (Safe Custody) Regulations 1973. Suppliers of CD cabinets can confirm that a cupboard meets the legal requirements. Appleton House DS0000061570.V365192.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a clear and accessible complaints procedure, which includes timescales for the process and service users can be confident that their views would be listened to and acted upon, any complaints are logged and responded to appropriately. The homes policies and procedures help to protect service users from any form of abuse. EVIDENCE: The home’s completed AQAA told us that the home has a clear and accessible complaints procedure and this was seen on the day of the visit. Residents told us that they were aware of the homes complaints procedure and said they would speak to a member of staff if they had any concerns. The manager showed us the complaints log and this showed that there had been 7 complaints made to the home since the last inspection and these had been made by a resident at the home and had been satisfactorily resolved by the home’s manager. Staff members spoken to were also aware of the complaints procedure and what action they should take if anyone wanted to make a complaint. The home has a copy of the Hampshire Adult Protection procedure and has a whistle blowing policy and a copy of the department of health guideline “No Secrets”. Staff also receive training with regard to adult protection and POVA as part of their induction, there is also annual training in Safeguarding. The manager was aware of what action to take and staff members spoken to confirmed that they had received training and were aware of their responsibilities in this area. Appleton House DS0000061570.V365192.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): 24 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users live in a homely and comfortable environment and the home is clean and hygienic and free from offensive odours. EVIDENCE: The home is pleasantly decorated throughout and furnished with good quality furniture and furnishings. Each resident has their own bedsit, which has a kitchen and shower room facilities. We looked at a vacant resident’s room and this was appropriately furnished and we were informed that the room would be decorated to the resident’s choice once a new placement was made. There is a large communal lounge where residents can relax and there is a quiet room fitted with a computer and access to the internet, which residents can use. There is also a small enclosed garden with a sitting area. Residents can choose to spend their time in their own bed-sit or in the communal areas of the home. Residents spoken with said that they were happy with the home and one resident told us that he would like to move rooms and the manager told us that they were looking into this for the resident. All areas of the home were clean and tidy. The residents are responsible for keeping their own Appleton House DS0000061570.V365192.R01.S.doc Version 5.2 Page 18 rooms clean and tidy and free from clutter and they are supported by staff once a week to clean and tidy their rooms and they also assist staff in the cleaning of communal areas, one resident told us that he likes to help the staff keep the home clean and tidy. A weekly health and safety check is undertaken and records of this are kept. The home has separate facilities for laundering clothing and this is equipped with an industrial washing machine with sluice facility and an industrial tumble drier. Each resident has an allocated day to do his laundry, however all residents are free to use the laundry facilities any time they are free. Staff supports the residents to undertake their laundry if needed and there were systems in place for washing any soiled items. Residents and staff are provided with gloves and aprons when dealing with contaminated waste and the home has policies and procedures on infection control and staff receive training in this area. Appleton House DS0000061570.V365192.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): 32, 33, 34 & 35 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. Competent, qualified and appropriately trained staff supports residents and meet their needs. The homes recruitment policy and practice protect residents. EVIDENCE: There is a good staff mix at the home and all staff are encouraged and supported to undertake National Vocational Training. Currently the home has over 90 of its staff members who have completed NVQ training or equivalent with 8 members of the staff team holding NVQ3. We looked at the staff rota and this showed that there is a minimum of 3 staff members on duty during the day with one awake staff member and one sleep in at night. Additional staff are provided to facilitate activities and appointments and the manager deploys her staff effectively to ensure the residents needs are met. Staff meet with the resident monthly to establish what they want to do and how this can be supported so that there are suitable numbers of staff available. Residents spoken with said that there was always sufficient staff on duty to give them the support they needed. Appleton House DS0000061570.V365192.R01.S.doc Version 5.2 Page 20 The organisation has a human resources department who assist in the recruitment of new staff, application forms are sent out and the manager of the home shortlists applicants for interview. We were told that residents are encouraged to be involved in the interview process and new staff only start at the home after all employment checks have taken place. Recruitment records were seen for 2 members of staff and these contained application form, refs x 2, Criminal record Bureau & Protection of Vulnerable Adults check, Passport, birth certificate, photo and qualifications. Staff spoken with told us that their recruitment was thorough. The organisation that runs the home has a training co-ordinator who provides training for all staff employed at the homes. Staff undertake induction training, which is linked to NVQ, and is completed within the first 6 weeks of employment. Mandatory training is carried out in; moving and handling, fire safety, adult protection, medication, first aid, health and safety, food hygiene and infection control. Specialist training is also made available to meet the needs of residents and this includes; mental health, learning disability, autism, person centred planning, self harm, Strategies for Crisis Intervention and Prevention(SCIP) and managing challenging behaviour. Staff members spoken with confirmed that they had received a good induction and said that there was regular training provided at the home. Appleton House DS0000061570.V365192.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents benefit from a well run home and the views of residents and other interested parties are sought on how the home is meeting needs. The health, safety and welfare of residents and staff are promoted and protected. EVIDENCE: The manager has been running the home for 3 years and has completed the registered managers award and has NVQ 4 in Care. She is currently undertaking a Foundation degree in Health and social care at a local university, with a specialist pathway in mental health attached to the degree. The manager has overall responsibility for the general running of home and is supported by a good staff team. During the visit the manager was able to answer any questions asked of her and all records and documents were up to date and readily available. The manager works well with her team and the residents, and she operates an open door policy. Both Residents and staff spoke highly of the manager and comments received were “if I have any Appleton House DS0000061570.V365192.R01.S.doc Version 5.2 Page 22 problems she will sort them out for me” and “she is very fair and always explains things clearly” The manager completed the homes AQAA in detail and this gave us good clear information about the service. The provider carries out regular regulation 26 visits to the home in accordance with the regulations and reports of these visits were available at the home. There are regular staff and residents meetings and minutes of these meetings are kept. The organisation sends out questionnaires to residents and other stakeholders to seek their views on how the service is operating and the manager informed us that she receives copies of the responses for her home. Residents told us that they have weekly support sessions with their key team and this gives them the opportunity to discuss any issues they may have about how the home is run. The fire logbook was inspected and all appropriate testing and checks have been recorded. Appropriate certificates were in date for gas safety, fire alarms systems and equipment, private electrical equipment and fixed wiring. There is an in date fire risk assessment for the building and regular health and safety monitoring takes place. Appleton House DS0000061570.V365192.R01.S.doc Version 5.2 Page 23 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 4 33 4 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 4 14 X 15 3 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 4 X 4 X X 3 X Appleton House DS0000061570.V365192.R01.S.doc Version 5.2 Page 24 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 Appleton House DS0000061570.V365192.R01.S.doc Version 5.2 Page 25 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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