Care Home: Casterbridge House

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What the care home does well Assessments are available and staff are competent in reviewing and reassessing residents changing health and welfare needs in order that these needs are continuously met at Casterbridge House in the manner preferred by the resident. Staff have intrinsic knowledge of residents needs, and their individual communication methods which supports the care planning process with residents, their carers and advocates in full participation. Written information based on the knowledge of staffs understanding of residents enable care needs to be acknowledged, understood and met in a respectful and thoughtful approach. Care records seen were clear, detailed and provided all necessary information concerning residents care needs and general well-being although DRH is considering changing the system to one of `Human Givens` which, as an approach to meeting needs and helping people meet their potential is not dissimilar to the person centred approach already in place, one which focuses on what people need to happen in their lives in order for them to be mentally, physically and emotionally healthy. In-house and community leisure facilities are at the disposal of residents with each persons needs being assessed and acknowledged with respect for their interests, hobbies and enjoyment. Residents are able to maintain links with family and friends and relationships between residents are upheld, supported and maintained as appropriate. Casterbridge House provides residents with a wholesome and varied diet dependent on individual tastes and requirements, care staff do the catering although residents are involved in menu planning and sometimes shopping for groceries. Personal health care is provided by community health care teams; although registered nurses are employed at the home, Casterbridge House is not registered to provide nursing care but the skill and competencies of these staff is valuable in recognising a need where medical attention may be required. Residents are supported in maintaining appointments with health care practitioners and health screening occurs as appropriate for each resident. Residents can be assured that any complaints or concerns will be listened to as appropriate procedures are in place to ensure that any complaints or incidents are managed effectively. Casterbridge House provides residents with a comfortable, homely environment in which to live. Health and safety, hygiene and well equipped and adapted facilities enhance residents lifestyles within the house. Staff at the home are well trained and competent, recruitment practices ensure that only staff suitable to work with vulnerable adults are employed and ongoing training programmes ensure staff remain up to date with current practice. The home is managed well by Mrs Buckley with the support of deputy manager and cohesive staff team, Dorset Residential Homes management team also have a regular presence in the home and staff confirmed they were comfortable in their relationship with senior managers. What has improved since the last inspection? What the care home could do better: One requirement has been made as a result of this inspection concerning management of medication. Whilst the home`s policy is robust, staff need to follow it to ensure best practice is maintained. All medicines must be signed for and an audit trail of boxed and bottled medicines must be evident. It has also been recommended that a thermometer is used to measure the temperature of the homes medication storage facilities. CARE HOME ADULTS 18-65 Casterbridge House 753 Dorchester Road Upwey Weymouth Dorset DT3 5LF Lead Inspector Jo Palmer Unannounced Inspection 28th July 2008 10:45 Casterbridge House DS0000020436.V362449.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 Casterbridge House DS0000020436.V362449.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. Casterbridge House DS0000020436.V362449.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Casterbridge House Address 753 Dorchester Road Upwey Weymouth Dorset DT3 5LF 01305 813466 01305 815282 casterbridge.house@virgin.net 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) Dorset Residential Homes Mrs Sally Buckley Care Home 10 Category(ies) of Learning disability over 65 years of age (10) registration, with number of places Casterbridge House DS0000020436.V362449.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 29th August 2006 Brief Description of the Service: Casterbridge House is a Registered Care Home providing personal care for up to 10 people who have learning disabilities and additional physical disabilities. The home is operated by Dorset Residential Homes, a registered charitable trust that operates a number of care homes in Dorset. Located on the northern outskirts of Weymouth, the home is a short journey from the town centre. There are local shops, pubs and a post office near to the home. An adapted multi person vehicle is available and the home is also on a main public transport route. The property is a large detached 2-storey house, which has been extended and adapted to meet the needs of residents who may have additional physical disabilities. Accommodation is provided on two floors with the first floor access via a lift. There are 2 single bedrooms and 4 double bedrooms, one of the double bedrooms has en-suite facilities. The rear garden is fully accessible for all the residents. On the ground floor there is a large communal lounge/ dining room and a separate conservatory. There is a good size kitchen, separate laundry and utility area. The home provides sufficient bathrooms and toilets; the ground floor bathroom is equipped with a ceiling track hoist. The home has specific equipment for residents based on an assessment of their individual needs. A copy of the last inspection report is available directly from Casterbridge House or from Dorset Residential Homes head office in Dorchester. Current fees are £1046 but may vary according to the individual’s support needs. Casterbridge House DS0000020436.V362449.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 3 Star. This means the people who use this service experience excellent quality outcomes. The unannounced inspection took place on the 28th July 2008 between 10.45am and 2.45pm; Sally Buckley Registered Manager was present throughout and the deputy manager also assisted with the inspection. This was the first key inspection since August 2006. In February 2008 an Annual Service Review took place where information gained about the service since the 2006 inspection was used to assess the home’s progress and performance, the information did not result in a change to the inspection plan. The purpose of the visit was to monitor the home’s performance against the key minimum standards. Information was gathered from discussion with the manager and staff, from a review of relevant records and documentation, a tour of the premises and observation of residents interacting with staff in the home. None of the residents available at the time of inspection were able to engage in significant conversation during the inspection. What the service does well: Assessments are available and staff are competent in reviewing and reassessing residents changing health and welfare needs in order that these needs are continuously met at Casterbridge House in the manner preferred by the resident. Staff have intrinsic knowledge of residents needs, and their individual communication methods which supports the care planning process with residents, their carers and advocates in full participation. Written information based on the knowledge of staffs understanding of residents enable care needs to be acknowledged, understood and met in a respectful and thoughtful approach. Care records seen were clear, detailed and provided all necessary information concerning residents care needs and general well-being although DRH is considering changing the system to one of ‘Human Givens’ which, as an approach to meeting needs and helping people meet their potential is not dissimilar to the person centred approach already in place, one which focuses on what people need to happen in their lives in order for them to be mentally, physically and emotionally healthy. In-house and community leisure facilities are at the disposal of residents with each persons needs being assessed and acknowledged with respect for their interests, hobbies and enjoyment. Residents are able to maintain links with family and friends and relationships between residents are upheld, supported and maintained as appropriate. Casterbridge House DS0000020436.V362449.R01.S.doc Version 5.2 Page 6 Casterbridge House provides residents with a wholesome and varied diet dependent on individual tastes and requirements, care staff do the catering although residents are involved in menu planning and sometimes shopping for groceries. Personal health care is provided by community health care teams; although registered nurses are employed at the home, Casterbridge House is not registered to provide nursing care but the skill and competencies of these staff is valuable in recognising a need where medical attention may be required. Residents are supported in maintaining appointments with health care practitioners and health screening occurs as appropriate for each resident. Residents can be assured that any complaints or concerns will be listened to as appropriate procedures are in place to ensure that any complaints or incidents are managed effectively. Casterbridge House provides residents with a comfortable, homely environment in which to live. Health and safety, hygiene and well equipped and adapted facilities enhance residents lifestyles within the house. Staff at the home are well trained and competent, recruitment practices ensure that only staff suitable to work with vulnerable adults are employed and ongoing training programmes ensure staff remain up to date with current practice. The home is managed well by Mrs Buckley with the support of deputy manager and cohesive staff team, Dorset Residential Homes management team also have a regular presence in the home and staff confirmed they were comfortable in their relationship with senior managers. What has improved since the last inspection? No requirements were made as a result of the last inspection. The AQAA (Annual Quality Assurance Audit) submitted prior to this inspection highlighted what the home feels they have improved in the last 12 months, these include: • • • • • • • Review of assessment forms Appointment of independent advocate for each resident Workshops for staff to gain knowledge into the human givens approach and a staff ‘away day’ Continuous monitoring and updating of care needs Policies and procedure review A review of accommodation with proposal for relocation More responsibility given to senior staff Casterbridge House DS0000020436.V362449.R01.S.doc Version 5.2 Page 7 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. Casterbridge House DS0000020436.V362449.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Casterbridge House DS0000020436.V362449.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care files hold records of assessments and reviews providing staff with detailed information needed to support each resident and meet their needs in their preferred way EVIDENCE: At the time of inspection, all residents had been living at the home for some time and were therefore well known to staff. It was evident however that information that has been gathered from previous care placements has been used to formulate an on-going profile of the resident’s care needs and their preferences for daily routines and lifestyle. Casterbridge House DS0000020436.V362449.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 excellent This judgement has been made using available evidence including a visit to this service. Systems are in place to provide staff with the information they need to meet the health, personal care and social needs of residents. Staff knowledge and understanding of each residents needs and their methods of communicating them supports a good individual care planning approach. EVIDENCE: A review of residents ‘Life and support plans’ demonstrate that all aspects of health and welfare have been considered and acknowledged by staff and that residents participate in formulating these and reviewing them. Each resident’s care file contains information about their personal care needs and any supporting medical and health and safety information as well as a comprehensive description of the residents communication abilities, mental and emotional well-being, their relationships and community presence and their rights, individuality, dignity, choice and control. Review meetings are held regularly and include the resident, key staff, relatives and other support workers as appropriate; the record of these demonstrates that the resident’s Casterbridge House DS0000020436.V362449.R01.S.doc Version 5.2 Page 11 preferred lifestyle is being met or where the plan has been altered to accommodate any changes. Daily activity records are held detailing the resident’s participation in their chosen activity as outlined in their support plans. Risks are assessed as part of the home’s care planning approach and are reviewed regularly, care records held information for each resident identifying specific risks and ways of managing them. Any risks identified such as those of scalding, road safety, bathing, use of transport etc along with individual considerations such as self-harm, panic and anxiety, and weight loss for example were weighed up against the residents rights to take some risks to enhance their independence and control whilst maintaining their safety. Staff spoken with demonstrated an inherent respect for the residents and their individual needs and were able to respond appropriately using their knowledge of each residents specific means of communication. Casterbridge House DS0000020436.V362449.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. Residents are able to take part in appropriate activities and are supported in maintaining links with the local community. Family and friends are welcomed into the home and staff support residents relationships within the home and residents rights, independence and privacy are upheld. The meals are wholesome and varied, choice is available and individual tastes and requirements are catered for. EVIDENCE: Records examined relating to daily routines and activities and discussion with staff evidenced that residents have access to a range of activities and opportunities in the local community including shopping trips and day trips to local places of interest. Staff at Casterbridge House also provide ‘in house’ activities and entertainment including arts and crafts, film afternoons and individual activities on a one to one basis that a resident may prefer. Records Casterbridge House DS0000020436.V362449.R01.S.doc Version 5.2 Page 13 indicated in some instances that a resident would enjoy ‘watching staff work’ when tidying their room, one residents helps with household chores and one chooses to ‘enjoy company’ of others although not to participate in conversation. Residents are involved in menu planning and meals are made accordingly, each resident’s individual dietary requirements are catered for including likes, dislikes and the need to have meals cut up small or liquidised. Catering is undertaken by care staff on a rotational basis, each member of staff are food handlers having undertaken the appropriate food hygiene training and a well equipped, domestic style kitchen enables resident participation where appropriate although staff confirmed that residents tend not to get involved. Each week, a take-away meal is ordered according to the likes and preferences of the residents, some may have fish and chips, some may like an Indian or Chinese meal. Records are held of meals served in the home and what each resident takes, this references well with the nutritional assessments and care plans which identify weight issues and nutritional needs. Casterbridge House DS0000020436.V362449.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. Residents are supported in their daily routines, personal, health and social welfare by staff with whom they have built relationships and who treat them respectfully and with dignity. Residents are supported in maintaining appointments with health care professionals and systems are in place to support their medical needs although some advancement of medication management is necessary to ensure sound systems are maintained. EVIDENCE: Care records identified staff members responsible for each residents care; each resident has a key worker and has built a rapport with that person with whom to communicate their needs and care requirements through the care planning and review process. As well as detailed assessments and support plans, a précis of the resident’s daily routine is held directing staff toward appropriate and well thought out care practices from enabling the resident to choose their time of waking, what clothes they would like to wear, how their personal care needs are to be met including preferred and safe mobilisation, how they will spend their day, what they like to eat and drink and at what times and what Casterbridge House DS0000020436.V362449.R01.S.doc Version 5.2 Page 15 time they like to retire. Night routines are also recorded detailing any nighttime requirements. Medical appointments are made and kept accordingly and residents are supported in attendance at clinics, surgeries, opticians etc. Where routine health screening is advised, staff at the home ensure a multi-disciplinary approach to decision making regarding the value of such screening (eg cervical smears, mammograms etc) depending on the residents understanding of the procedure. General health care is monitored by staff at Casterbridge House including skin viability assessments, urinalysis (as appropriate) and weight, annual health checks are carried out by the resident’s GP. Medication is managed on behalf of residents by staff in the home. A review of the medicines systems including stocks and records evidenced that there is no excess stocks held and daily medicines are issued from a monitored dosage system (MDS) managed by the supplying pharmacy. Medicines are issued in 28 day blister packs, each marked with the day and time the resident should receive their medicine, the MDS packs are supplied with medication administration records (MAR) that are to be signed each time a medicine is administered. Some medicines, not suitable for packaging in blister packs are issued in their original containers. Some anomalies were noted with medicine administration, there were some gaps in recording not indicating whether a medicine had been given, refused, spoilt or was not required and some boxed/bottled medicines were not supported by audit, for example, the number of remaining tablets in the box was not consistent with the number issued and those having been administered to the resident. Resident’s care records and review notes indicated however that medications were given as prescribed and it is therefore considered that these gaps in recording were due to occasional staff error rather than mal-administration of any medicines. The medicine cabinet is sited in the hallway of the home, although there is no natural sunlight in this area and therefore no excessive temperatures, it is recommended that a thermometer is used to monitor the temperature of the cupboard and storage area as some liquid medicines need to be stored below 21 degrees C. Casterbridge House DS0000020436.V362449.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. Satisfactory complaints and protection policies are in place to ensure residents concerns are listened to and acted upon. EVIDENCE: A review of the home’s policy and procedure manual evidenced that appropriate policies are in place with correct procedural guidance for staff in the event of any complaints or referrals being made. Sally Buckley, registered manager confirmed that no complaints or referrals have been made concerning residents or any aspects of the home’s operation. A review of staff training records demonstrated that staff have received the appropriate level of training with regard to adult protection; the home follows the guidance of the local authority and Department of Health guidelines relating to any issues of safe guarding vulnerable adults. Casterbridge House DS0000020436.V362449.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 and 30 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. As an older style converted house, the home has been well adapted to meet the needs of the residents accommodated and hygiene and health and safety regulations are respected. EVIDENCE: Casterbridge House provides comfortable, homely accommodation for those living there. Communal space is domestic in feel, is clean and well maintained and staff make the effort to ensure that mobility aids and equipment are stored when not in use thereby maintaining that homely feel. Shared space includes a lounge, dining area, conservatory and the gardens. The kitchen is sited off the dining area and is accessible to residents if they choose. The majority of bedrooms are shared and although residents initially did not have a choice over sharing, records indicate that this was discussed with their carers, families and advocates and the decision was made on their behalf, many of the residents have known each other for many years from previous care environments and sharing with a friend has not caused them any discomfort. Casterbridge House DS0000020436.V362449.R01.S.doc Version 5.2 Page 18 All shared rooms have privacy screens and each resident has their own space within the room where it was evident that rooms had been personalised to a great degree with personal effects and belongings. The home provides well-equipped bathroom and toilet facilities and aids and adaptations are installed where necessary to assist with mobility around the home. The last inspection made the recommendation that the bathrooms were refurbished and although this has not been done, the recommendation is withdrawn in view of plans for relocation. Casterbridge House is clean and there are no offensive odours, infection control procedures are followed and hand-washing facilities are sited around the home for staff including anti-bacterial soap and disposable towels. Laundry facilities enable a good service, the washing machine has sluicing and high temperature programmes and soiled articles are handled appropriately. Casterbridge House DS0000020436.V362449.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Training is provided to staff in order that they have the skills and competencies to do their jobs. Safe staff recruitment practice is used. EVIDENCE: Eight staff employed at the home have achieved NVQ level 3 and one member of staff is currently working toward this. One member of staff is currently undertaking the NVQ level 2 award programme. Two members of staff are first level registered nurses and two staff are second level registered nurses. Although not registered to provide nursing care, the skills and competencies brought to the home by this level of training is considered valuable. Staff files seen demonstrated appropriate recruitment. Application forms are used to recruit into vacant posts, applicants provide personal details as required in Schedule 4 (Care Homes Regulations) including work history and qualification, provide names of referees and sign a Rehabilitation of Offenders statement. References, POVA (Adult Protection) and Criminal Records checks are made before an applicant is successful and starts employment at the home. Casterbridge House DS0000020436.V362449.R01.S.doc Version 5.2 Page 20 A training matrix was seen which demonstrated that all staff have undertaken mandatory training programmes including moving and handling, food hygiene, health and safety, life support, fire safety and care planning. Casterbridge House DS0000020436.V362449.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. Residents are can be confident that the home is well managed and that systems are in place that centre around their care needs. Management practices and records kept, confirm the health and safety of people in the home. EVIDENCE: Sally Buckley, registered manager of Casterbridge House is a first level registered nurse and a competent manager who is able to efficiently run the home with the support of the deputy manager, a cohesive staff team and the support of the DRH management team. She is aware of the processes set out in the National Minimum Standards and of the need to keep up to date with practice and to develop the service. All sections of the Annual Quality Casterbridge House DS0000020436.V362449.R01.S.doc Version 5.2 Page 22 Assurance Assessment (AQAA) were completed and the information gives a reasonable picture of the current situation within the service. Mrs Buckley has completed the NVQ level 4 award and the recently appointed deputy manager has applied to start his course. The AQAA outlines the home’s proposed developments over the next 12 months and from information provided it is evident that regular reviews of services and care practices take place with the views of residents, advocates and relatives being considered. A Fire Risk Assessment is in place detailing homes fire precautions, regular testing and maintenance of fire fighting equipment, alarms and emergency lighting systems, and all staff receive fire safety and awareness training regularly. Policies and procedures are in place offering procedural guidance for staff in relation to COSHH, infection control, food hygiene, health and safety and moving and handling. Individual risk assessments are carried out for residents highlighting any possible risks around the home and detailing action necessary to avoid such risks. Casterbridge House DS0000020436.V362449.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 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 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 4 14 X 15 3 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 1 X 4 X 3 X X 3 X Casterbridge House DS0000020436.V362449.R01.S.doc Version 5.2 Page 24 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA20 Regulation 13 Requirement There must be no gaps in medication administration records and all medicines must be supported by a recorded audit of their use. Timescale for action 01/09/08 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 Refer to Standard YA20 Good Practice Recommendations It is recommended that a thermometer is used to measure and maintain safe temperatures for medication storage. Casterbridge House DS0000020436.V362449.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA 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 Casterbridge House DS0000020436.V362449.R01.S.doc Version 5.2 Page 26 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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