Care Home: Arnold Road

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What the care home does well The holistic needs of the residents are identified through a comprehensive assessment process and changing needs and aspirations are reflected in support plan. Residents can participate in a good range of social activities and their rights and responsibilities are upheld. A well-balanced menu is provided which is based on the preferences of the residents. Health and personal care support is of a good standard. Medicine management promotes the resident`s safety and independence. Complaints, concerns and allegations are taken seriously and acted upon. The home provides a safe, well-maintained environment, which is very pleasant, comfortable and clean throughout. Appropriately trained and supervised team of staff are employed at the home and the staff recruitment practices are effective in promoting the safety of residents. The home is run and managed by a person who is fit to be in charge. The health, safety and welfare of residents is promoted through effective routine maintenance. What has improved since the last inspection? Risk assessments are now undertaken for the use of bed rails. Residents receive a well-balanced and nutritious menu. Medication management practices have improved. Staff are aware of the actions to be taken should they suspect abuse is happening in the home. Overnight resident checks are now performed. The number and skill mix of staff now meets the needs of the residents. CARE HOME ADULTS 18-65 Arnold Road 514 Arnold Road Bestwood Nottingham NG5 5HN Lead Inspector Steve Keeling Unannounced Inspection 14th May 2008 09:30 Arnold Road DS0000070275.V364416.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 Arnold Road DS0000070275.V364416.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. Arnold Road DS0000070275.V364416.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Arnold Road Address 514 Arnold Road Bestwood Nottingham NG5 5HN TO BE ADVISED 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) londonroad@tiscali.co.uk Milbury Care Services Ltd Mrs Joanne Louise Ollerenshaw Care Home 10 Category(ies) of Learning disability (10) registration, with number of places Arnold Road DS0000070275.V364416.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered persons may provide the following category of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission are within the following category: Learning disability - code LD The maximum number of service users who can be accommodated is 10. 20th February 2008 2. Date of last inspection Brief Description of the Service: The premises of 514 Arnold Road have been purpose built as a care home and are situated on the edge of the town of Arnold, just north of Nottingham city. There is spacious accommodation for up 10 young adults. The service provided is aimed at young adults with learning disability and additional physical needs. There are two ground floor self-contained flats within the establishment. Two other bedrooms are located on the ground floor and six others are on the first floor. The communal rooms include a multi sensory room, activities room and separate lounge and dining rooms. Wide, lightweight doors have been used to meet the needs of wheelchair users and fixed hoisting equipment is provided. Staffing is provided according to needs and this can be on a 1:1 basis. Milbury Care Services Ltd provides a detailed guide to the services at Arnold Road and fees are given as commencing at £1645.00 per week. Arnold Road DS0000070275.V364416.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for residents and their views on the quality of service provided. This process considers the provider’s capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provision that need further development. One inspector conducted the unannounced visit. The main method of inspection used was called ‘case tracking’ which involved selecting residents and looking at the quality of the care they receive by speaking to them, observation, reading their records and asking staff about their needs. The manager and two members of staff also spoken with as part of this inspection. Documents were read as part of this visit and medication management was inspected to form an opinion about the health and safety of residents at the home. A partial tour of the building was undertaken which included the case tracked resident’s bedrooms and the communal areas they frequent to make sure that the environment is homely and safe. A review of all the information we have received about the home since the last inspection was considered in planning this visit, which included an Annual Quality Assurance Assessment (AQAA), provided by the manager. The quality rating for this service is 2 star this means the people who use this service experience good quality outcomes. What the service does well: The holistic needs of the residents are identified through a comprehensive assessment process and changing needs and aspirations are reflected in support plan. Residents can participate in a good range of social activities and their rights and responsibilities are upheld. A well-balanced menu is provided which is based on the preferences of the residents. Health and personal care support is of a good standard. Arnold Road DS0000070275.V364416.R01.S.doc Version 5.2 Page 6 Medicine management promotes the resident’s safety and independence. Complaints, concerns and allegations are taken seriously and acted upon. The home provides a safe, well-maintained environment, which is very pleasant, comfortable and clean throughout. Appropriately trained and supervised team of staff are employed at the home and the staff recruitment practices are effective in promoting the safety of residents. The home is run and managed by a person who is fit to be in charge. The health, safety and welfare of residents is promoted through effective routine maintenance. 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. Arnold Road DS0000070275.V364416.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 Arnold Road DS0000070275.V364416.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 and 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The holistic needs of the residents are identified through comprehensive assessments thus ensuring the facilities and services at the home can need their needs. EVIDENCE: The AQAA said that “The service has comprehensive and detailed Service User Guide and Statement of Purpose and these are provided, as far as possible, in formats that are accessible to the service user prior to moving in that will give them plenty of information about the home”. A resident confimed that she received the pre admittance information and found it informative. Information provided by the manager, within the AQAA stated that “senior care planners identify and match potential service users with potential services. Initial assessments are then carried out that identify basic information and contact details as well as information on areas such as communication skills, specific health needs, daily living skills etc. We talk to service users, other carers, care managers to try and get as much information as possible to make an accurate assessment of the ability of the service to meet the persons Arnold Road DS0000070275.V364416.R01.S.doc Version 5.2 Page 9 support needs, wishes and aspirations. If it is agreed that the placement should go ahead then we carry out a more detailed assessment of need and draft a transition plan, detailing specifics of the individuals move to the home”. We can then begin to arrange transition visits to the home and visits by our own staff to the service user in their current placement or daycentre, collage or school. Transition plans are tailored to individual need and wherever possible exceed National Minimum Standards”. An examuination of pre admittance assessment documentation and discussions with a resident supported the information within the AQAA and it was evident that significant time and effort is spent on making admissions to the home person centred and well managed. It was also shown in the case tracked resident’s support plans that the assessment process utilises information from advocates such as social service department when available. The pre-admittance assessment documentation are very well organised and stored securely to promote the residents confidential information. Arnold Road DS0000070275.V364416.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 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are assured that their changing needs and aspirations are reflected in their support plan. Residents are supported to take risks and have an active independent lifestyle. EVIDENCE: Information provided within the AQAA states “From the point at which service users move in to Arnold Road they are encouraged to develop and express individual needs and choices from simple issues such as how to decorate their rooms to more complex issues, such as choosing a form of medical treatment which may involve issues of capacity to consent”. A resident said that she is encouraged to take control of her life and is encouraged to be as independent as possible whist being supported by a dedicated staff team. Arnold Road DS0000070275.V364416.R01.S.doc Version 5.2 Page 11 Support plans are developed in consultation with residents and they are based on the holistic needs assessment. Support plans are person centred and focuses on the individual’s strengths and personal preferences, which includes their short and long-term goals and aspirations. Support plans are written and reviewed effectively and a resident confirmed that she contributes to the development of her support plan, with the aid of her “key worker” to ensure the plans are up to date and pertinent to her needs, wishes and choices. The resident also said that she is able to see their support plans at any time. Support plans also address the resident’s health needs and a resident said that she receives interventions from members of the multi-disciplinary medical team such as general practitioners, district nurses, specialist nurses, psychiatry services, occupational therapists band social workers. Information within the AQAA stated “As for risk assessments, the home operates a system of consent forms, whereby the choices an individual makes about regular aspects of their life are recorded and thus give consistency of service delivery”. Support plans examined on the visit contained comprehensive risk assessments, which includes risk assessments and consent for the use of bed rails. Risk assessments are regularly reviewed to ensure risks are managed positively whilst promoting the resident’s independence and safety. The support plans and risk assessment documentation were found to be individualised, extensive and exceptionally well presented to ensure that people who are not familiar with the individual could deliver a personalised and consistent person centred service. The support plans are securely stored to ensure that the resident’s confidentiality is maintained at all times. Arnold Road DS0000070275.V364416.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 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can participate in a good range of social activities. The resident’s rights and responsibilities are upheld and they can maintain contact with their family and friends. A well-balanced menu is provided which is based on the preferences of the residents. EVIDENCE: A resident confirmed that she is able to enjoy a full range of social activities both within the home and within the broader community and confirmed that her views are always taken into consideration to ensure her interests are identified and met. Arnold Road DS0000070275.V364416.R01.S.doc Version 5.2 Page 13 Information provided qwithin the AQAA Stated “The development of support plans reflect the lifestyle choices of each individual and specific areas of support plans deal with specific lifestyle choices. For example, individual support plans deal with areas such as cultural and religious observances, others may address how a service user likes to dress or have their hair styled. Lists of likes and dislikes are recorded in service users plans and these may reflect specific likes or dislikes or more generic lifestyle choices such as hobbies or forms of social and recreational activities, behaviour or food choices” Records of social activities showed that varied activities are made available for residents, which include Bowling, attending pubs and clubs, attending café, local walks and supported holidays, planned for later in the year. Residents can access education facilities such as day centres and colleges. A resident said she is supported to be as independent as possible and confirmed she is involved in daily living activities in the home which includes taking responsibility for some meal preparation and performing domestic duties, whilst being supported by the care staff. In house entertainment systems are provided, such as plasma screen television, music centre, DVD player and a computer system. A Resident and members of staff confirmed that the routines are flexible in the home and residents often stay up late to watch the television if they wish. The manager said that an “open door policy” is encouraged at the home and a resident confirmed the open door policy and said that that support is given to maintain relationships with their family and friends at all times. The residents, in relation to meal planning and preparation are encouraged to plan a weekly menu. Residents take responsibility, under the guidance and supervision of staff, to purchase food products and prepare meals and snacks thus enhancing their independent living skills. In response to a requirement made at the previous inspection a “healthy option” menu has been introduced. A Resident said that the meals are very good and a choice is always made available, she also confirmed that drinks and snacks are readily available on request. A resident confirmed that her respect and dignity is always promoted and said that routines in the home are flexible and her choice is respected at all times We observed that interactions between the staff and residents were very respectful, unrushed and considerate to their needs and wishes. Arnold Road DS0000070275.V364416.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 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s health and personal care support is of a good standard. Medicine management promotes the resident’s safety and independence. EVIDENCE: Information provided within the AQAA states “The delivery of care is directed primarily by the needs and preferences of the individual and where this is not possible then this is documented along with the reasons for not complying. Service users are supported to complete as much of their own personal grooming as possible and are encouraged to choose toiletries, make-up, clothes etc that reflect their own choices, tastes and preferences. While the home provides an already sympathetic environment for people who may need physical support with their personal care we will continue to provide aids and adaptations that promote safety and support in this area, ensuring Arnold Road DS0000070275.V364416.R01.S.doc Version 5.2 Page 15 that these aids and adaptations are the most suitable for the individual, seeking professional advice where necessary”. A resident said that they she is supported to be independent and can take responsibility for her personal care needs. The residents stated that when support is required the staff are responsive to her needs and preferences. The ability of residents to self administer their own medication is risk assessed prior to admission. If the residenet is assessed as safe, appropriate storage facilities are availble and residnets would be supported in the process. A brief examination of medication procedures was undertaken and it was evident that systems are in place to ensure that medicine management promotes the health and wellbeing of the residents. Staff receive accreditted training on the principles of administration and control of medicines as well as specific training on the use of Monitored dosage system (MDS). From a large pharmaceutical retailer. At a previous inspecion a requirement was made to ensure that consistant practice in relation to the recording of medication administration is achived. The case tracked residents Medication Administration Records (MAR) were examined. The records had no gaps present and medication administration was recorded effectively which included “as required” medication. Medication, which requires refrigeration, was stored within a secure fridge. The temperature within the medication fridge is recorded on a daily basis. Temperature monitoring sheets showed that the temperature was outside the required 2-8 degrees centigrade. To address the issue the thermostat was adjusted accordingly. Arnold Road DS0000070275.V364416.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 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and their representatives are assured that their complaints, concerns and allegations are taken seriously and acted upon. EVIDENCE: A Resident said she felt safe, secure and very well looked after. The resident said that should she have any concerns or complaints she would speak with the manager and felt confident that any issues would be addressed effectively. A complaints procedure is displayed in a prominent position in the home to enable residents or their representatives to access it. The procedure is also provided to all residents within the SUG, which clearly identifies whom the complainant should contact and specifies times scale in which the complainant will receive a response. To further promote the safety of the residents the revised Nottinghamshire Safeguarding Adults policy is available in the home and staff confirmed that the policies are accessible at all times. A complaints/concerns book is maintained by the manager. One concern has been made since the last unannounced inspection was undertaken. The concerns/complaints book showed that the concern had been managed effectively with documented actions and outcomes. Arnold Road DS0000070275.V364416.R01.S.doc Version 5.2 Page 17 CSCI has not received any complaints or made any safeguarding adult referrals relating to the service provision at the home since the last unannounced inspection. Training records showed that staff have received training in Safeguarding Adults, staff spoken confirmed this and were able to provide a description of appropriate actions they would initiate should they suspect abuse was happening. Residents are encouraged to manage their own financial affairs. Secure facilities are available for residents to store small amounts of spending money and financial records showed that all transactions are recorded for expenditures thus protecting the residents from financial abuse. At a previous inspection a requirement was set to ensure that planned overnight resident checks are performed in all instances, documentation was available to demonstrate that compliance has been achieved. Arnold Road DS0000070275.V364416.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 and 30. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Resident’s benefit from a safe, well-maintained environment, which is very pleasant, comfortable and clean throughout. EVIDENCE: The premises are purpose built to accommodate the needs of the residents. There are two ground floor self-contained flats which are exceptionally well maintained and equipped with an open plan kitchen / diner / lounge and walk way to a bedroom with en-suite bathroom. Two other bedrooms are located on the ground floor and six others are on the first floor. All bedrooms have en-suite bathrooms are very well maintained. Arnold Road DS0000070275.V364416.R01.S.doc Version 5.2 Page 19 On the day of this inspection visit we found all areas well maintained and homely, offering residents a comfortable and safe environment. Resident’s bedrooms were homely, safe and personalised with many personal possessions such as family pictures, a television, radio and ornaments to meet their needs, a resident said she was proud of her personal accommodation and of the home in general. The communal rooms included the multi sensory room, which was fully equipped with a range of multi sensory materials and light systems. There was also an activities room, lounge and dining room all of which were spotlessly clean and fit for purpose. All areas within the home were accessible to residents in wheelchairs and an extensive range of equipment is on hand to promote the residents independence. Arnold Road DS0000070275.V364416.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, 34 and 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported by appropriately trained and supervised team of staff and recruitment practices are effective in promoting the safety of residents. EVIDENCE: At the previous inspection a requirement was made to ensure that there is sufficient staff on duty at all times. An examination of the staffing rota showed that the staffing level meets the needs of the residents and the manager confirmed that she is no longer required to perform direct care duties. A resident said there is always enough staff on duty and staff are always available when she needs them. She said that all the staff are very competent and confident in performing their duties. Staff recruitment records, which are very well maintained, showed that members of staff only commence employment once satisfactory Protection of Vulnerable Adult (POVA) checks and Criminal Record Bureau (CRB) checks Arnold Road DS0000070275.V364416.R01.S.doc Version 5.2 Page 21 have been obtained, together with two satisfactory references, thus promoting the safety and wellbeing of residents. Information provided by the manager, within the AQAA showed that the service has achieved a target of 80 of staff trained, to National Vocational Qualification (NVQ) level two and above to ensure a suitably qualified workforce is employed at the home. Staff records also showed that a comprehensive staff-training programme is also provided and staff was able to confirm that they have received the training and said that a great deal of importance is placed on the provision of training events. Arnold Road DS0000070275.V364416.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, 39 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is run and managed by a person who is fit to be in charge. A resident’s consultation process is performed to provide residents and their relatives with the opportunity to contribute to developments within the home. The health, safety and welfare of residents is promoted through effective routine maintenance. EVIDENCE: The registered manager has eight years experience as a manager of residential services for adults with learning disabilities and has almost completed the NVQ 4 Registard Managers Award (RMA). Arnold Road DS0000070275.V364416.R01.S.doc Version 5.2 Page 23 The manager and her line manager perform formal monthly quality auditing practices to ensure that safe working practices are adhered to. CSCI receive a copy to the quality auditing documentation on a monthly basis. The manager said and residents confirmed that a monthly consultation process is performed with residents and their key workers to discuss any issues relating to care provision at the home. The consultation process also provides residents with the opportunity to contribute to any developments within the home. Staff spoken with were very confident in the managers leadership and managerial skills and said they felt well supported and valued. A resident also expressed satisfaction in relation to the management structure saying that the manager and care staff at the home are “very good”. The manager said that it is planned that a yearly resident surveys are to be utilised to determine the satisfaction levels of residents at the home. As the home has only recently been registered the process has not been initiated as yet. Staff confirmed that the policies and procedures are readily accessible for guidance, and information provided within the AQAA showed that Policies and Procedures are reviewed appropriately. Information provided within the AQAA showed that resident’s health, safety and wellbeing is promoted by the provision of effective routine maintenance. A “comments book” is provided in the foyer of the home to allow visitors to the to comment on the service provision. Comments made within the book were very positive and included “A lovely place to live, bright cheerful environment with lovely staff, how all homes for young people should be” and “great home, great staff, fantastic environment, keep it up”. As mentioned earlier in the report it was evident that the manager has invested a great deal of time and effort in performing her managerial duties professionally and with confidence and competence. The manager should be commended on the quality of her documentation especially in relation to the assessment process and support planning process. Arnold Road DS0000070275.V364416.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 4 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 4 25 x 26 x 27 x 28 x 29 x 30 4 STAFFING Standard No Score 31 x 32 3 33 x 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 x 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 4 x 3 3 x 3 x Arnold Road DS0000070275.V364416.R01.S.doc Version 5.2 Page 25 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 Arnold Road DS0000070275.V364416.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 Arnold Road DS0000070275.V364416.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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