Care Home: Badgers Wood

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What the care home does well People who are considering moving into the home are provided with information to help them decide if the home will be suitable for them. Good assessment procedures ensure their needs will be understood and can be met. People can be confident their needs are understood and care will be provided in line with their individual wishes and preferences. They can be confident their personal information will remain confidential. People who live in the home are encouraged to be as independent as possible. They enjoy opportunities to take part in a wide range of leisure activities, education and employment. People can be confident their personal and healthcare needs will be met in a way that respects their individual wishes and preferences and upholds their privacy and dignity. They are protected through safe systems for handling medication. People are listened to and are encouraged to offer comment or complaint. They are protected from abuse. People benefit from the spacious and wellfurnished accommodation; everyone has their own room.People who live in the home benefit from the support of the committed, well trained and competent staff team who understand their needs and actively promote their best interests. The home is managed in the best interests of the people who live there. Effective quality assurance systems promote year on year improvement in the service. What has improved since the last inspection? A designated person now undertakes monthly visits and writes a report on the home as part of the quality assurance system. The management of the home now ensure a record of medication returned to the pharmacy is held in the home. The damaged ceiling in one of the bedrooms has been repaired. What the care home could do better: Care plans should be expanded to reflect a more person centred approach. Daily records should evidence the implementation of the care plan. Individual Risk assessments should be expanded to provide clearer guidance for staff on the action they need to take to minimise risk in all areas of peoples` lives. Staffing levels at weekends should be reviewed to ensure that opportunities for people to take part in outside leisure activities at weekends are not restricted. Risk management in relation to infection control and storage of cleaning products needs updating to further improve the protection of residents. CARE HOME ADULTS 18-65 Badgers Wood Badgerswood Slade Road Ottershaw Surrey KT16 0JN Lead Inspector Ruth Burnham Unannounced Inspection 28th November 2007 08:30 Badgers Wood DS0000034871.V354669.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 Badgers Wood DS0000034871.V354669.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. Badgers Wood DS0000034871.V354669.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Badgers Wood Address Badgerswood Slade Road Ottershaw Surrey KT16 0JN 01932 795010 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) Surrey County Council - Adults & Community Care Vacant Care Home 20 Category(ies) of Dementia (1), Learning disability (15), Learning registration, with number disability over 65 years of age (3), Sensory of places impairment (2), Sensory Impairment over 65 years of age (2) Badgers Wood DS0000034871.V354669.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Accommodation and services may be provided to named persons aged 65 years and over with the prior written agreement of the CSCI. The matters detailed in the attached schedule of requirements, must be completed within the given timescales. Accommodation and services may be provided to named persons aged under 65 years with the prior written agreement of the CSCI within the category of Dementia 19th December 2006 Date of last inspection Brief Description of the Service: Badgers Wood is a large detached care home situated in the village of Ottershaw in Surrey. The home is owned and managed by Surrey County Council. Accommodation is arranged over two floors and there are two respite rooms. There is a communal lounge with separate dining area and a large kitchen. The home has a computer suite on the ground floor. There is a wellmaintained garden with barbecue area and ample garden furniture. Car parking spaces are available to the front of the premises. There is a complex fee structure. The level of support people need determines the level of fees charged in the home. Information about fees and charges can be obtained on application to Surrey County Council. Badgers Wood DS0000034871.V354669.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A site visit was undertaken by the Commission for Social Care Inspection as part of the key inspection. Ruth Burnham, Regulation Inspector, carried out the inspection. The assistant manager assisted throughout the visit which took 6 hours commencing at 8.30 a.m. and finishing at 2.30 p.m. There are currently fifteen residents living in the home, and the majority of the residents have lived in the home for some time. Five residents were in the home on the day of the site visit. Other residents were seen and spoken to before they left for their day activities. During the visit nine residents, 2 members of staff and the assistant manager were spoken to. The registered manager has recently ceased employment at the home. Feedback was given to the interim manager following the inspection. A full tour of the premises was undertaken. Five care plans and four staff files were inspected. Sixteen responses were received from surveys sent out to people by the Commission before the visit. These responses were largely positive, the only negative comments related to staffing levels at weekends and anxieties about future plans for the home. The home also completed an annual quality assurance audit for the commission which was used as part of the inspection. The inspector would like to thank the residents, the assistant manager and staff members for their time, assistance and hospitality during the inspection. What the service does well: People who are considering moving into the home are provided with information to help them decide if the home will be suitable for them. Good assessment procedures ensure their needs will be understood and can be met. People can be confident their needs are understood and care will be provided in line with their individual wishes and preferences. They can be confident their personal information will remain confidential. People who live in the home are encouraged to be as independent as possible. They enjoy opportunities to take part in a wide range of leisure activities, education and employment. People can be confident their personal and healthcare needs will be met in a way that respects their individual wishes and preferences and upholds their privacy and dignity. They are protected through safe systems for handling medication. People are listened to and are encouraged to offer comment or complaint. They are protected from abuse. People benefit from the spacious and wellfurnished accommodation; everyone has their own room. Badgers Wood DS0000034871.V354669.R01.S.doc Version 5.2 Page 6 People who live in the home benefit from the support of the committed, well trained and competent staff team who understand their needs and actively promote their best interests. The home is managed in the best interests of the people who live there. Effective quality assurance systems promote year on year improvement in the service. 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. Badgers Wood DS0000034871.V354669.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 Badgers Wood DS0000034871.V354669.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): 1–5 People who use the service experience good outcomes in this area. People who are considering moving into the home are provided with information to help them decide if the home will be suitable for them. Good assessment procedures ensure their needs will be understood and can be met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People who are considering moving to the home are provided with information about what life is like there to enable them to make a decision. Information is contained in the statement of purpose and service user guide. The assistant manager is in the process of updating these documents to reflect recent changes. People are also able to experience what life is like before moving in, they are able to visit the home for short stays to meet staff and other residents. People who move into the home only do so following a thorough assessment of their needs; this includes gathering detailed information from health and social care professionals. People only move in once it has been established the home is suitable for them and can meet their needs. Where people are placed in an emergency situation this information is obtained as soon as possible after the event. Information is recorded on individual care plans and includes religious and cultural wishes and preferences. Where people have individual specialist Badgers Wood DS0000034871.V354669.R01.S.doc Version 5.2 Page 9 needs staff receive additional training and the home liaises with relevant health professionals to ensure these needs can be met. Everyone who moves into the home is provided with a statement of terms and conditions to enable them to understand their rights and responsibilities. The manager said that staff spend time explaining these documents and any other written information to each new person. Information is available in a variety of formats to suit the needs of the individual. Badgers Wood DS0000034871.V354669.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 – 10 People who use the service experience good outcomes in this area. People can be confident their needs are understood and care will be provided in line with their individual wishes and preferences although documentation needs some improvement. People can be confident their personal information will remain confidential. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Each person who lives in the home has an individual plan of care. Care plans are developed with the involvement of residents, their care managers and relevant healthcare professionals. The assistant manager explained how the process is being updated to ensure a more person centred approach in recording the care plan, most current care plans are very brief. New care plans will provide more information about people’s background, social histories, interests, wishes and preferences, this will in turn provide clearer guidance for staff about how people want their care delivered. Advice was given that daily recording should be improved to reflect the care plan, currently staff make entries on a variety of forms when specific events occur such as a visit to the GP. For most people there is no daily record that Badgers Wood DS0000034871.V354669.R01.S.doc Version 5.2 Page 11 comments on the general well being and day-to-day life of the resident to help staff to pick up and respond to changes. Current care plans are reviewed every month with more formal reviews taking place at regular intervals or as needs change. People can be confident their needs will continue to be met. Good examples were seen where specialist services have been involved in setting up revised plans of care and advising staff how to adapt the service to meet peoples’ changing needs. People’s right to make decisions about how they wish to live their lives are respected. People are supported to make decisions in a number of ways. Each resident has an allocated key worker who is trained to offer one to one support and who knows the resident well and understands his or her needs. People who were spoken to during the visit and contacted beforehand clearly understood the key worker system. The assistant manager said that an independent advocate was coming to meet with residents this week to assist them in the consultation process about future change in the service. Residents meetings are held to enable residents to have a say in the running of the home. These meetings are also used to give opportunity for people to plan holidays and outings, notes of residents meetings were seen during the visit. People who live in the home are also involved in staff selection. Applicants are interviewed by a residents’ panel as part of the recruitment process. People are supported to manage their own finances and are protected from financial abuse. Where the home acts on behalf of less able residents records are kept of all transactions. Those seen as part of the inspection were in order and up to date, receipts are kept of all expenditure. It was noted that people are expected to buy their own bed linen; the manager was advised that the regulations state that the registered person shall provide bedding; the home provides items such as duvets and pillows. People are supported to be as independent as possible. There are risk management systems in place to protect people from harm and enable people to manage risk responsibly. Each person has individual risk assessments as part of their care plan. Where risk is identified action is agreed with the person to minimise the risk. Full details of any restrictions are recorded. Some discussion took place about expanding these risk assessments to provide clearer guidance for staff on the action they need to take to minimise risk in all areas of peoples’ lives. People can be confident their personal information remains confidential. Personal information is stored securely and is available solely to authorised and appropriate people. Badgers Wood DS0000034871.V354669.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): 11 – 17 People who use the service experience good outcomes in this area. People who live in the home are encouraged to be as independent as possible. They enjoy opportunities to take part in a wide range of leisure activities, education and employment. Opportunities for leisure activities outside the home at weekends may be restricted. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People are supported to be as independent as possible. They are actively encouraged to make their own choices and to live their lives as they wish, so far as they are able. Records seen indicate that religious and cultural needs are known and respected. People spoken with during and contacted prior to the visit confirmed this. However they also said that opportunities to choose what to do in the evenings or at weekends were restricted. Staff spoken to confirmed that there was not enough staff on duty, particularly at weekends, to support people with leisure activities of their choice such as bowling, cinema trips and other outings. Badgers Wood DS0000034871.V354669.R01.S.doc Version 5.2 Page 13 People who live here help with running the home. Household tasks are undertaken by the residents with staff support to enable people to develop independent life skills. It was observed that staff knock before entering residents bedrooms and that personal care is offered discreetly. People are addressed in the way that they prefer. Everyone is registered on the electoral roll. One person has a part time job at a local school; others attend the College of Further Education and day centres. Information is available to help people choose activities, outings and holidays. Leaflets about forthcoming events such as concerts, cinema and a number of other activities are available in the home. There were a number of photographs in the hallway of days out and holidays that people had enjoyed last year and in previous years. Everyone has the opportunity to go on a holiday of his or her choice. Regular trips are also organised to places of interest. People are supported to maintain contact with family and friends, visitors are welcome in the home at all reasonable times. Peoples’ privacy is respected; they are offered a key to their room. It was clear throughout the visit and in responses received to surveys before the visit that staff are committed to promoting the interests of people who live in the home. Interaction observed during the visit was warm, supportive and respectful. Staff who were spoken to during the visit knew the residents well and understood their needs and aspirations. People who live in the home are actively involved in planning and preparing meals. People who were spoken to said they enjoyed the food; the main meal is eaten in the evening during the week as many people attend day centres, local colleges or are employed. Those who are out for the day take a packed lunch. Meals are served in pleasant surroundings. The dining rooms are well furnished. Food intake and nutritional content are monitored and all residents are weighed monthly. People who have special dietary needs can be confident they will be catered for, advice is sought from the dietician where necessary. Badgers Wood DS0000034871.V354669.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 – 21 People who use the service experience good outcomes in this area. People who live in the home can be confident their personal and healthcare needs will be met in a way that respects their individual wishes and preferences and upholds their privacy and dignity. They are protected through safe systems for handling medication. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People who live in the home are provided with care in a way that respects their individual wishes and preferences and upholds their privacy and dignity. Routines are flexible and relevant, people who were spoken to confirmed they are able to choose when to go to bed and when to get up and are supported to choose their own clothes, hairstyles and other aspects of personal grooming. People are supported with their healthcare needs; they visit the local G.P when necessary and have annual health checks. The home has good links with the local surgery and the community nurse visits people where additional support is needed. People are supported to access other healthcare professionals where necessary, including the dentist, optician, chiropodist and physiotherapist. Where people have specialist healthcare needs, the home liaises with specialist healthcare professionals to ensure they receive the best Badgers Wood DS0000034871.V354669.R01.S.doc Version 5.2 Page 15 possible care. It was impressive to see how the service has adapted to meet the needs of an older person who is experiencing dementia. People are protected from harm through the safe handling of medication. Independence, privacy and dignity are promoted in this area through the provision of individual lockable storage facilities in each person’s room. Wherever possible people are supported to manage their own medication. The system for medication administration was seen and was carried out to a high standard. The Medication Administration Record (MAR) sheets were seen, these were well maintained and up to date. Badgers Wood DS0000034871.V354669.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 People who use the service experience good outcomes in this area. People who live in the home are listened to and are encouraged to offer comment or complaint. They are protected from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People who live in the home are encouraged to offer comment or complaint; this is done through a variety of means such as residents meetings and one to one contact with staff and management. People who were spoken to during or contacted prior to the visit said they knew who to talk to if they were unhappy. There have been no complaints since January 2006; the assistant manager stated the home had not received any complaints. There is a clear complaints procedure and records seen indicate that complaints would be responded to promptly. The complaints procedure is available in pictorial form using widget symbols; some discussion took place about using improved pictorial formats in line with more recent research, which would be easier for people with learning disabilities to understand. All relatives also receive a copy of the complaints procedure. People who live in the home can be confident they are protected from abuse. All staff have completed training on the protection of vulnerable adults. The assistant manager confirmed that as part of the induction process staff undertake this training. All staff are checked through the Criminal Records Bureau before appointment. People are protected from financial abuse through good systems for managing peoples monies. The home supports people to manage their personal allowances. Records were checked and details of all transactions are well documented. Badgers Wood DS0000034871.V354669.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 People who use the service experience good outcomes in this area. People benefit from the spacious and well-furnished accommodation. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People who live in the home benefit from the spaciousness and cleanliness of the premises. The home is well furnished and everyone has his or her own room. Communal areas of the home include a lounge on the ground floor and an activities room on the first floor where people can watch films or play pool or table tennis. There is a separate dining room and kitchen on each floor. People benefit from access to the large garden to the rear of the property, which is mainly laid to lawn with a built in BBQ. People are encouraged to personalise their bedrooms and those seen were homely. One resident showed the inspector his bedroom, this had been recently decorated and the resident e had chosen the colour scheme. People are supported to choose the colour schemes in their rooms to suit their preferences. There are two bedrooms on the ground floor, which are used for short stays to provide respite for carers or for emergency admissions. This Badgers Wood DS0000034871.V354669.R01.S.doc Version 5.2 Page 18 was discussed with the acting manager who is hoping to relocate respite services in a separate property next to the home to ensure that the lives of permanent residents are not disrupted. People have access to well-equipped bathrooms and toilet facilities, which are suitably located. The home has sought advice from Occupational Therapists to ensure the home is suitably equipped to meet the needs of all the people who live there, regardless of age or ability. There is a small laundry on the ground floor, which is well – equipped and accessible to residents who are supported to do their own laundry. Badgers Wood DS0000034871.V354669.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): 31 – 36 People who use the service experience good outcomes in this area. People who live in the home benefit from the support of the committed, well trained and competent staff team who understand their needs and actively promote their best interests. People would benefit from a review of staffing levels at weekends to ensure people can access leisure activities of their choice. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People who live in the home benefit from the support of the well trained staff team. It was noted that staff had a good understanding of peoples’ needs, were respectful and had a good rapport with the residents. Conversations with staff during the visit showed a high level of commitment to promoting the best interests of people who live in the home. On the day of the site visit three staff were on duty plus an additional member of staff working one to one with a resident who needs additional support for the early part of the morning. Responses to surveys sent out to residents as part of the inspection stated they are unable to do all the things they want to do at weekends, as there are not enough staff free to take them out. The interim manager agreed to review staffing levels in light of these responses. Badgers Wood DS0000034871.V354669.R01.S.doc Version 5.2 Page 20 People who live in the home are protected through robust recruitment procedures, which include checks through the Criminal Records Bureau and taking up 2 written references prior to appointment. Four staff files were examined. These were up to date and contained all the relevant documents as detailed in Schedule 2 of The Care Homes Regulations 2001. All staff received a copy of the General Social Care Council code of conduct. People who live in the home can be confident staff are well-supervised and competent to carry out their duties. A number of staff had completed NVQ Level 2 & 3, others are in the process of completing these awards. All staff undertake additional training relevant to understanding the specific needs of the people they care for. Refresher courses are arranged regularly for all mandatory training. All staff had regular formal supervision sessions and all new staff follow an induction programme, which is covered over the first week of employment; the second week is spent shadowing an experienced member of staff. Badgers Wood DS0000034871.V354669.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 – 43 People who use the service experience good outcomes in this area. The home is run in the best interests of the people who live there. Effective quality assurance systems promote year on year improvement in the service. People are protected through systems to promote health and safety although risk management in relation to infection control and storage of cleaning products needs updating to further improve the protection of residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager has recently left the home. Interim arrangements leave the two assistant managers taking responsibility for the day to day running of the home with oversight from the registered manager of another home owned by Surrey County Council and a service manager. These arrangements appear to have been successful in the short term in maintaining a good level of service for people who live in the home. Badgers Wood DS0000034871.V354669.R01.S.doc Version 5.2 Page 22 People can be confident the home is managed in their best interests. There is currently some anxiety about future plans for the home; people are undergoing community assessments to ascertain whether they would benefit from a move into more independent living. The acting manager stated that everyone currently living in the home would be able to choose, either to move on, or to stay at Badgers Wood once the consultation period and educational programme was completed. An independent advocate has been brought in to ensure the views of people who live in the home at this time are heard. People are benefiting from the ongoing programme of improvements, which are informed by the home’s quality assurance system. People are involved in decisions about how the home is managed through annual residents’ surveys and monthly residents’ meetings. People who were spoken to said they enjoyed living in the home. Records seen during the visit were up to date and well maintained. The assistant manager completed the Annual Quality Assurance Audit for the Commission as part of the inspection. This shows that people are protected and their health and safety are promoted through good fire safety systems and regular safety checks on all equipment and installations. People are protected from harm through safe working practices with the exception of infection control where some shortfalls were noted; there may be some risk of infection where communal bathmats and bars of soap are used. The assistant manager was advised that there should be clear policies and procedures in place where staff have to deal with soiled linen or clothing. The interim manager agreed to ensure that all staff receive updated infection control training. Further discussion took place about the storage of cleaning materials which residents who are able to, use to clean the bathrooms after having a bath. Currently these are stored on open shelves. The assistant manager was advised that updated risk assessments should be recorded to cover everyone who lives in the home to ensure that no one is at risk through accidental misuse of these products. Badgers Wood DS0000034871.V354669.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 3 2 3 3 3 4 3 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 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 2 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 2 3 LIFESTYLES Standard No Score 11 3 12 3 13 4 14 2 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 3 3 3 3 3 2 x Badgers Wood DS0000034871.V354669.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA14 Regulation 12(3) Requirement The registered person shall, for the purpose of providing care to service users, and making proper provision for their health and welfare, so far as practicable ascertain and take into account their wishes and feelings. Timescale for action 31/01/08 2. YA42 13 In that peoples’ choice of activities at weekends should not be unduly restricted. The registered person shall make 31/01/08 suitable arrangements to prevent infection, toxic conditions and the spread of infection at the care home. In that all staff should receive adequate training in infection control, advice should be sought from the local environmental health officer on the safety of using communal bathmats and bars of soap. There should be clear procedures in place to ensure that soiled linen is handled safely. The registered person shall ensure that all parts of the home to which service users have Badgers Wood DS0000034871.V354669.R01.S.doc Version 5.2 Page 25 access are so far as reasonably practicable free from hazards to their safety; Specifically the practice of storing cleaning materials on open shelves in bathrooms should be properly risk assessed. 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. 3. Refer to Standard YA6 YA9 YA33 Good Practice Recommendations Care plans should be expanded to reflect a more person centred approach. Daily records should evidence the implementation of the care plan. Risk assessments should be expanded to provide clearer guidance for staff on the action they need to take to minimise risk in all areas of peoples’ lives. Staffing levels at weekends should be reviewed to ensure that opportunities for people to take part in outside leisure activities at weekends are not restricted. Badgers Wood DS0000034871.V354669.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection South East Regional Contact Team The Oast Hermitage Court Hermitage Lane Maidstone, Kent 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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