Care Home: Ashwood Cheshire Home - Leonard Cheshire Disability

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What the care home does well People living at Ashwood Cheshire are supported to live full and active lives by a staff team that have received a good level of training. The home is comfortable and has a homely, clean, friendly environment. The recruitment procedures are thorough and protect people who use the service. What has improved since the last inspection? An office space has been set up at the rear of the property. This is well equipped and provides a private space for meetings. What the care home could do better: The service needs to develop Health action plans for people living in the home as required by the Department of Health Valuing people strategy.The Registered Manager needs to undertake a quality assurance exercise toobtain the views of members of staff, relatives and other interested parties the quality of the service provided and where improvements to the service may be required. CARE HOME ADULTS 18-65 Ashwood Cheshire Home 141 Chesswood Road Worthing West Sussex BN11 2AE Lead Inspector Jan Aston Unannounced Inspection 27 August 2008 01:00p th Ashwood Cheshire Home DS0000014378.V369004.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 Ashwood Cheshire Home DS0000014378.V369004.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. Ashwood Cheshire Home DS0000014378.V369004.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ashwood Cheshire Home Address 141 Chesswood Road Worthing West Sussex BN11 2AE 01903 230930 01903 239878 gill.donovan@LCDisability.org www.LCDisability.org Leonard Cheshire Disability 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) Mrs Gillian Donovan Care Home 8 Category(ies) of Learning disability (8), Learning disability over registration, with number 65 years of age (3) of places Ashwood Cheshire Home DS0000014378.V369004.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. A maximum of 8 service users may be accommodated at any time of whom three persons over the age of sixty five years may be in the category LD(E). Only service users aged between 18 and 65 may be admitted. A maximum of eight service users in the category Learning Disability may be accommodated. 11th January 2007 Date of last inspection Brief Description of the Service: Ashwood Cheshire Home is a care home registered to accommodate up to eight residents in the category Learning Disability (LD), to include three persons over the age of 65 years, Learning Disability (LD) Elderly (E). The property is a large detached house located in a busy residential road in East Worthing. The home is within easy access of Worthing town centre and seafront. The building is an attractive double fronted two-storey house that stands in a street of similar properties. Bedrooms are located on both ground and first floor level. The Leonard Cheshire Foundation privately owns the service. The Responsible Individual on behalf of the organisation is Mr Peter Bray. Mrs Gill Donovan is the registered manager in charge of the day-to-day running of the home. Ashwood Cheshire Home DS0000014378.V369004.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 Star. This means the people who use this service experience Good quality outcomes. This inspection assessed all of the key standards for services for Younger Adults as determined by the Commission’s inspection methodology plus three other standards. The inspection took into account the previous key inspection report and also information from the Annual Service Review that was undertaken in November 2007. The Annual Quality Assurance Assessment form was used in planning and preparation for the inspection. Easy read surveys for people living in the home and for members of staff were sent to the service prior to the inspection. At the time of the visit none had been returned. A visit to the service took place on Wednesday 27th August 2008. Just over five hours were spent in the home. Two people living in the home were at home at the start of the inspection and all people living in the home were seen later in the day. Three members of staff and the Registered Manager were spoken with during the inspection. The Inspector looked around the home, examined a sample of records in relation to care plans, training, staff, complaints, accidents and Health and safety checks. Observations were made of the interactions between staff and people living in the home. What the service does well: What has improved since the last inspection? What they could do better: The service needs to develop Health action plans for people living in the home as required by the Department of Health Valuing people strategy. The Registered Manager needs to undertake a quality assurance exercise to Ashwood Cheshire Home DS0000014378.V369004.R01.S.doc Version 5.2 Page 6 obtain the views of members of staff, relatives and other interested parties the quality of the service provided and where improvements to the service may be required. 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. Ashwood Cheshire Home DS0000014378.V369004.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 Ashwood Cheshire Home DS0000014378.V369004.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): Standards 1, 2 and 5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Information is available to help people make a choice about whether the home is suitable for them. Their needs are assessed prior to moving into the home so that they and their families or representative know that the service is able to develop a plan of care that will meet those needs. EVIDENCE: There is a Statement of Purpose and Service User Guide in place that provides information to prospective service users about Ashwood Cheshire. The Service User Guide has been produced in a pictorial format to make the information more accessible to people using the service. It was noted that the Service user Guide requires updating with staff details and with the new contact details of the Commission. A sample of records was examined in relation to people living in the home. The sample included two people who had lived in the home for many years and one person who had moved into the home in November 2007. It was seen the Registered Manager had visited the person who moved into the home in November to assess their needs prior to a place being offered. Ashwood Cheshire Home DS0000014378.V369004.R01.S.doc Version 5.2 Page 9 The Registered Manager confirmed that a further visit had been made as well as visiting the person’s relative. The prospective service user also made a visit to the home before moving in. Other information about the person’s needs had been obtained from their Social Worker. A licence agreement is provided to each person that provides the details of the terms and conditions of living in the home. This has also been developed into a pictorial format. The terms and conditions that were examined had been signed as agreed by a relative. The Registered Manager told the Inspector that the licence agreements are currently under review to improve the information provided. Ashwood Cheshire Home DS0000014378.V369004.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): Standards 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. The care needs and support required by each individual are recorded on an individual care plan so that people living at the home and their relatives/advocates know that their needs have been identified and will be met. Members of staff have good information in order to support people to meet their needs and enable people to make choices and decisions in their lives in a safe way. EVIDENCE: A sample of records relating to three people living in the home was examined. Each person has a secure filing box that is kept in their rooms that contains some of their personal records. This includes an individual care plan that sets out how the service should support each person, a lifestyle plan that gives information about a person’s life history and important people and events and photograph albums that contain a record of holidays, activities and celebrations. Ashwood Cheshire Home DS0000014378.V369004.R01.S.doc Version 5.2 Page 11 The individual care plans were detailed and provided staff with information about how best to provide support to people whilst promoting people to make choices but still keeping safe. The care plans had been reviewed within the last six months. Individual care plans indicate choices about a person’s daily routines and activities. Members of staff support a person to live an active a life as possible and one that suits their needs. Due to the level of disability of people living in the home some choices and decisions are made on their behalf. The Registered Manager confirmed that she has undertaken training on the Mental Capacity Act and that members of staff have received some information at staff meetings and are aware of their responsibilities under this act. Potential risks for each person in their daily lives had been considered and assessed to minimise the risk. This information had been recorded on risk assessments and it was noted that they had been reviewed within the last six months. Information was also available for members of staff in how to support people where they may display challenging behaviour. Ashwood Cheshire Home DS0000014378.V369004.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): Standards 12, 13, 15, 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are encouraged to take part in leisure activities and live with flexible routines within the home. They are supported to maintain links with their families, friends and the community so that they can continue to live a fulfilling lifestyle. EVIDENCE: The individual care plans that were examined recorded a person’s interests and hobbies and what activities they may like to take part in. A record is kept of what each person has done each day. From the records seen this included structured activities such as attending day centres, lunch clubs as well as spending time at home, going out for coffee or lunch. The Inspector was told that people living in the home had recently been to see a circus and one person had been away on a boating holiday. Music sessions take place in the home each week and a pat dog visits the home each fortnight. One person attends a keep fit class. Ashwood Cheshire Home DS0000014378.V369004.R01.S.doc Version 5.2 Page 13 Care records also showed that people access local facilities, shops, cafes, and the theatre. People living in the home are supported to maintain contact with their families. Records examined recorded the contact each person would like with family or friends and the service support people to maintain that contact. It was noted that relatives visit regularly and the service supports people to visit their relatives rather than them always coming to the home. It was observed that members of staff interacted with residents well and people living in the home appeared to be comfortable in their company. There is a four week menu plan in place. On the day of the visit people living in the home had their main meal in the evening. This was tuna pasta bake. Where people visit day centres during the day they take a packed lunch and a record is kept of what each person has each day. From the three care plans examined it was seen that the weight of each person is monitored and where necessary support provided with weight loss programmes and a consultation with a dietician had been accessed. From records examined in relation to members of staff training it was seen that each member of staff in the sample examined had undertaken food safety and hygiene course. The last Environmental Health Officer’s visit took place on the 29/1/08 and commented that it was nice clean premises. Ashwood Cheshire Home DS0000014378.V369004.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): Standards 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. People receive appropriate personal support and their health needs are met. Members of staff support people with taking medication and accurate records are kept to ensure medicines are given and stored safely. EVIDENCE: Members of staff support people living in the home with their individual personal care needs; some requiring full support whilst others prompting and encouraging. From the three Individual Service Plans examined it was seen that good information about the personal care needs of each individual are recorded along with guidance for members of staff to follow. From the daily records examined it was seen that people living in the home receive support to have a bath almost on a daily basis. There is a mix of both male and female staff working in the home so people have a choice about who provides support and same sex care is respected as far as possible. The induction training programme provided by the organisation provides information and guidance on how to support individuals with personal care needs. Ashwood Cheshire Home DS0000014378.V369004.R01.S.doc Version 5.2 Page 15 Members of staff spoken with said that the induction programme that was undertaken over three months provided the information and support needed to support people in the right way. Individual Service Plans include a section that records the name of the person’s G.P., dentist, chiropodist, optician and the date of the last check up and GP visit. It was seen from the care records examined that support and advice is sought from other health professionals such as speech and language therapists, psychologists and psychiatrists when required. The three Individual Service Plans examined had either not recorded the person’s last dental check up at all or for some considerable time. This was discussed with the manager who said that after the regular dental company was unable to continue providing a service it had been very difficult to find an NHS dental service that would be prepared to register people living in the home. In July of this year an NHS dental service has been found and now everyone is registered and will be seen within six to eight weeks. Health assessments and action plans that record a person’s medical history and how they should be supported to remain healthy as required by the Department of Health Valuing People strategy had not been undertaken with people living in the home in consultation with family or representatives where necessary. This was discussed with the Manager who confirmed that she had received training in how to undertake and compile health action plans and this work would be undertaken shortly. The home uses a monitored dose system that provides medication in blister packs for each person. The medication for each person is stored in a locked cabinet in their room. Other medication such as creams is stored in a different locked cabinet in the office within the home. A record of the medication taken by each person is kept and these records were accurate and up to date. The medication records for each individual has an identity sheet, that includes a photograph and information about their doctor, date of birth and any allergies, which they might have. From staff records it was seen that members of staff had received training in the administration of medication. The six o’clock medication administration was observed during the visit. The member of staff undertook this in the correct manner with each individual. Ashwood Cheshire Home DS0000014378.V369004.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): Standards 22 and 23. Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. The welfare of people using the service are promoted and protected by the homes policies and procedures on making complaints and identifying and responding to safeguarding matters. EVIDENCE: There is a clear complaints procedure that is contained in the homes Statement of Purpose and Service User Guide. It was noted that details about how to contact the Commission in respect of concerns or complaints required updating. Whilst people would find it difficult to make a formal complaint without assistance, the manner in which staff respect them indicates that they would make representation on their behalf should this be necessary. The organisation requires each service to record details of a complaint and send monthly audits of number of complaints to the organisation’s head office. This record was examined and showed no complaints recorded. Since the last inspection the Commission had been contacted twice in respect of concerns about staffing levels in the home. This will be discussed in more detail in the staffing section of this report. All members of staff receive training with regard to recognising signs of abuse and safeguarding adult procedures as part of their induction and refresher training is carried out annually. The home has a copy of the West Sussex Multi Agency Guidelines and also has a whistle blowing policy. Ashwood Cheshire Home DS0000014378.V369004.R01.S.doc Version 5.2 Page 17 Staff members spoken to confirmed that they had received training and were aware of their responsibilities in this area. The Registered Manager confirmed that she is attending training on the revised West Sussex multi-disciplinary safeguarding procedures in October. Members of staff will then also receive refresher training in these procedures. People living in the home are supported to manage their personal allowances each week. It was seen that a record is kept of any expenditure and receipts kept. A balance sheet records expenditure and balance. Each person has a cash tin where monies are kept. The financial records for three people living in the home were checked. The balance sheets showed items purchased and money spent and that receipts were kept. The balance shown on the sheet corresponded to the money in the cash tin. Ashwood Cheshire Home DS0000014378.V369004.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): Standards 24 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People live in a safe, homely and comfortable environment. EVIDENCE: Ashwood Cheshire is a property situated in close proximity of town centre facilities. It is a two-storey property that has a large lounge, dining room, kitchen/laundry area, downstairs toilet and separate bathroom. Two bedrooms are situated on the ground floor and others on the first floor. There is another bathroom and toilet on the first floor and a small office. A tour of the home was conducted and all areas of the home were well maintained. The furniture and fittings were of good quality and homely in appearance. The home was clean and hygienic. Cleaning of the home is the responsibility of members of staff and night staff undertakes most of this. A cleaner is also employed who comes into the home on a weekly basis. Ashwood Cheshire Home DS0000014378.V369004.R01.S.doc Version 5.2 Page 19 People have their own rooms, which are personalised with their own furniture and possessions and decorated to their choice. There is one shared room in the home and the two people sharing this room have done so for a considerable period of time. There is a bathroom on the ground floor of the property that is fitted with a hoist to assist people in accessing the bath. This was out of action for a period of time last year but members of staff spoken with confirmed that this has been working and is working currently. The Registered Manager told the Inspector that a replacement for this bath is being considered one that will better meet the needs of the people living in the home. The laundry room leads off the kitchen, however the Environmental Health Officer has accepted this. Procedures are in place for the safe transfer of soiled clothing to prevent cross contamination. Since the last inspection a large office has been created in a building in the garden at the rear of the property. This has provided a large office that is well equipped and space for private meetings. The records relating to the safety of the premises and utilities were examined. This demonstrated that regular safety checks are undertaken on utilities, equipment including fire equipment. Temperatures are checked on the hot water thermostatic safety valves that are fitted to each hot water outlet, fridge & freezer temperatures recorded and water systems tested for legionella. Risk assessments have been undertaken on equipment to ensure where people living in the home use this they are safe and to ensure safe working practices for members of staff. Ashwood Cheshire Home DS0000014378.V369004.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): Standards 32, 34, 35 and 36. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The wellbeing, health and security of people living at the home are being protected by the agency’s policies and procedures on recruitment, a good training programme and an effective staff team. EVIDENCE: Ashwood Cheshire accommodates eight service users. Eight people were living in the home at the time of the visit. On arrival at the home two people living in the home were at home supported by one member of staff and a team leader. The Registered Manager was also working in the home that day. Members of staff spoken with confirmed that usually two members of staff work in the home on each shift and at times three members of staff when there are activities. During the middle part of the day people living in the home go out to day centres and lunch clubs so it is only early morning, late afternoon and evening and weekends when all people living in the are at home altogether. At weekends some people visit their relatives or relatives take them out. Ashwood Cheshire Home DS0000014378.V369004.R01.S.doc Version 5.2 Page 21 Since the last inspection two concerns were raised with the Commission in November 2007 and in March 2008 about poor staffing levels in the home. This was discussed with the Registered Manager during this visit who explained the reasons for this and what action has been taken. The home is fully staffed apart from a few hours that are being used for extra support for activities. Five new members of staff have been employed and although the staff team and people living in the home have been through a disruptive period the staff team are now working well together and are an enthusiastic, positive and committed staff group. Members of staff spoken with said that they felt the staffing levels allowed them to do what was required and to support people living in the home well. They said that they felt the staff team was supportive and committed to ensuring that people living in the home have a good quality of life. They confirmed the training they had received had provided good information and experience to support people appropriately and well. Recruitment files for the three people who were seen working in the home during the visit and who had been employed since the last inspection were examined. It was seen that they had been asked to fill in an application form, and two written references had been obtained. There was also a Criminal record Bureau (CRB) and Protection of Vulnerable Adults (POVA) clearance for all three people in place which had been carried out prior to them starting work at the home. There is a training department and co-ordinator employed by the organisation to provide a training programme to care staff most of which is provided at the training centre. New members of staff are provided with induction training, which is based on “skills for care” guidelines and is linked to NVQ, and this is completed over three months. Mandatory training is carried out in; moving and handling, fire safety, medication, first aid, health and safety, food hygiene and infection control. Additional training is also carried out for managing challenging behaviour and NVQ training. Staff members spoken with confirmed that they had received a good induction and they had received training in all of the mandatory topics. Records relating to members of staff demonstrated that each member of staff receive regular supervision with the manager or team leader. Members of staff spoken with confirmed this. Ashwood Cheshire Home DS0000014378.V369004.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 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 well run with support from the organisation. People living in the home would benefit from a consultation exercise being undertaken to obtain feedback from staff, relatives and other interested parties about the quality of the support provided and any areas for improvement. The homes policies and procedures promote and protect the health safety and welfare of staff and residents. EVIDENCE: The manager of the home is registered with us and has completed the NVQ level 4 Registered Managers Award. She is also able to demonstrate that she updates her skills by attending further training. The organisation operates a quality assurance system that includes an audit of the service, staff consultation and surveys and a self-assessment report Ashwood Cheshire Home DS0000014378.V369004.R01.S.doc Version 5.2 Page 23 undertaken by the Registered Manager. The organisation organises monthly inspections of the service in line with regulation 26 of the Care Standards legislation and a written report is kept in the home. During the visit it was seen that regular Regulation 26 inspections had been taking place. The Registered Manager is responsible for obtaining feedback about the quality of the service from people who use the service, their families, advocates or stakeholders at least annually. There was no evidence of obtaining this feedback over the past year. This was discussed with the Manager who confirmed that this would be undertaken shortly particularly after such a change in the staff team. All utilities and equipment is serviced and checked regularly. Staff training records showed that members of staff are kept up to date in health and safety matters. There were no outstanding health and safety issues in the home at the time of the inspection. Ashwood Cheshire Home DS0000014378.V369004.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 X 4 X 5 3 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 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 2 X X 3 X Ashwood Cheshire Home DS0000014378.V369004.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. 1 2 YA19 YA39 Refer to Standard Good Practice Recommendations Health Action Plans Quality Assurance Ashwood Cheshire Home DS0000014378.V369004.R01.S.doc Version 5.2 Page 26 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. Extracts may not be used or reproduced without the express permission of CSCI Ashwood Cheshire Home DS0000014378.V369004.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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