Care Home: Downside House

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What the care home does well The home has a small and experienced staff team who have a good understanding of the individuals` needs. They treat people in a warm and respectful manner, which means that they can expect to receive care and support in a sensitive way. The home is comfortable, tastefully decorated and furnished to a very good standard. It provides a safe, peaceful and well-maintained environment. The home has good resources and facilities including up to date aids and adaptations. This helps enable people with disabilities to maximise their independence. The service is well run. The ethos is clear and is focused on positive outcomes for people living in the home. What has improved since the last inspection? This is the homes first inspection. What the care home could do better: The home has been registered for six months. We believe the home has made good progress in its initial stage and that it will continue to work in developing its aims and objectives in order that the National Minimum Care Standards are fully achieved and maintained. CARE HOME ADULTS 18-65 Downside House 62 The Down Trowbridge BA14 7NQ Lead Inspector Wendy Kirby Unannounced Inspection 14 January 2009 09:30 th Downside House DS0000072307.V373025.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 Downside House DS0000072307.V373025.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. Downside House DS0000072307.V373025.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Downside House Address 62 The Down Trowbridge BA14 7NQ 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) 01225 753485 Voyagecare.com Voyage Ltd Mr Leslie Malcolm Johnson Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Downside House DS0000072307.V373025.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: 2. Learning Disability (Code LD) The maximum number of service users who may be accommodated is 11. This is homes first Key Inspection Date of last inspection Brief Description of the Service: Downside House as a service consists of two houses, Lavender and Primrose. It was registered with The Commission for Social Care of Inspection in July 2008. Primrose and Lavender are designed, equipped, well maintained and staffed to care for the people living the home. Downside is managed by Mr Johnson and there is a deputy manager in both Primrose and Lavender. The home is situated in the pretty county town of Trowbridge and is easily reached via public transport. It is close to the town centre with easy access to shops and restaurants. Also within easy reach are local amenities such as a swimming pool, a large specialist college and many other facilities, such as open parks, sports centres and a bowling centre. The cost to live in the home varies between £1,500 and £1,650.00 dependent on individual need. Downside House DS0000072307.V373025.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 was Downsides first unannounced Key Inspection which included a visit to the home. The visit was completed by one inspector over one day and lasted approximately nine hours. Prior to the inspection we (The Commission) looked at various pieces of information to gather evidence in preparation for our visit, which included the following: The homes inspection record, which gives us an account of any information we have received about the home since the last inspection. The Annual Quality Assurance Assessment, known as an AQAA. The home is requested annually to complete and return this assessment to us by a specified time. We received the AQAA on time, which contained information about what the home considers it does well and what plans they have for further improvements in the coming year. During our visit we spoke with some of the people who live in the home, the deputy managers and other staff members who were on duty. Comments received will be referred to throughout this report. We also looked at how effectively staff engage with people in the home and how they were interacting and communicating with each other. We looked at four individuals care files, which included pre-admission assessments, care plans and risk assessments. We also looked at a number of records and files relating to the day-to-day running and management of the home. We spent time in all communal areas of the home and some of the bedrooms. We finished the inspection with a feedback meeting to the deputy managers who demonstrated a very caring, committed attitude to their roles and responsibilities in ensuring they provide quality of care to the people who use the service. The manager was not present on the day of our visit so we gave written feedback after the inspection. What the service does well: Downside House DS0000072307.V373025.R01.S.doc Version 5.2 Page 6 The home has a small and experienced staff team who have a good understanding of the individuals’ needs. They treat people in a warm and respectful manner, which means that they can expect to receive care and support in a sensitive way. The home is comfortable, tastefully decorated and furnished to a very good standard. It provides a safe, peaceful and well-maintained environment. The home has good resources and facilities including up to date aids and adaptations. This helps enable people with disabilities to maximise their independence. The service is well run. The ethos is clear and is focused on positive outcomes for people living in the home. 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. Downside House DS0000072307.V373025.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 Downside House DS0000072307.V373025.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): 2 and 4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People’s needs are assessed to ensure the home is suitable to meet individual requirements. EVIDENCE: Over the last six months there has been a steady flow of people being admitted to the home. The deputy managers were able to describe the process that is undertaken to ensure that a full assessment is conducted for people wishing to live in the home. We looked at the pre-admission assessments, which were comprehensive covering all activities of daily living, a full health screen and personal history background. The information gathered pre-admission should provide a sound benchmark of each persons ability, state of health prior to admission and subsequent needs when they move into the home. Downside House DS0000072307.V373025.R01.S.doc Version 5.2 Page 9 People wishing to live in the home, family and carers are involved in the preadmission assessment wherever possible and all information is used to determine the suitability of the placement. Where possible the home also obtains comprehensive assessments and care plans from other health and social care professionals involved, for example, social workers and hospital staff. We were told that people who were considering moving into the home have an opportunity to meet with people already living in the home and staff. Visits, sleepovers and outings are tailored to the individual. This transitional period can take up to two months before admission to the home. One person told us that their relative had visited and stayed in the home on several occasions before moving in permanently and that this had been useful. There is a policy to guide staff on the admission process. Downside House DS0000072307.V373025.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff have a good awareness of individuals needs and treat people in a warm a respectful manner, which means that they can expect to receive care and support in a sensitive way. People are supported to take risks in their daily lives within their home and out in the community. EVIDENCE: The paperwork format for peoples care files is new to the home but they are making good progress in the development of these. Staff have received training on how to develop them for individuals. The manager regularly audits the care files and gives written feedback and any action required to staff members. Downside House DS0000072307.V373025.R01.S.doc Version 5.2 Page 11 Each person has a portfolio with person centred assessments, which means that staff put the views, wishes, likes and dislikes of each person at the centre of all care provided. The information was informative and useful enabling staff members to provide the appropriate care to support health and social needs. From the initial pre admission assessments staff had identified needs enabling them to form written care plans. The plans that we looked at were detailed and person centred, including personal preferences and like and dislikes. Plans told us that people had specific requests and routines, this is very good practice and helps demonstrate that people are involved in deciding how they wish to receive care. The plans showed consistency in assessing, planning and evaluating care as required. Regular care reviews take place for people living in the home, which can include family members and Key Workers wherever possible. This allows the opportunity to discuss and evaluate care and any issues or concerns people might have. Staff demonstrated a clear understanding of peoples individual needs. Through observation and discussions with the staff we saw skills of sensitivity and warmth when communicating and delivering care to people living in the home. Some people have complex needs with varying impairments and learning disabilities. We were told about individual communication requirements and through patience and time the staff had identified effective methods of communication with individuals. Risk assessments were examined and showed us that staff were mindful of keeping people safe within their home and out in the community. Individual risk assessments detailed for example, how much supervision was required when visiting the GP, what risks were involved with regards to road safety and preparing meals and drinks in the kitchen. The deputy managers told us that the staff were empowering people to promote as much independence as possible. Downside House DS0000072307.V373025.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, 12, 13, 14, 15, 16, 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People enjoy a range of activities and are supported to live a fulfilling life in and out of the home. People are supported and encouraged to maintain firm connections with families and friends. People take an active role in promoting and maintaining a healthy well balanced diet. EVIDENCE: Care plans and discussions with staff demonstrated that the home was providing people with opportunities to develop social, emotional, communication and independent living skills. There was information on levels of independence and the level of support that was required by staff to support the people both in and outside of the home. Downside House DS0000072307.V373025.R01.S.doc Version 5.2 Page 13 Weekly activities and plans are reviewed with people, staff and families to ensure that they remain relevant to the individual. All individual tastes and preferences are taken into account. One person told us that they usually make decisions about what they want to do each day and that they are able to do what they want during the day and in the evening. It was evident that staff are respectful and working hard to promote peoples rights to choice in order to support this at all times. The AQAA told us that the home wants each person to have the opportunity to explore their own diversity and uniqueness and will support them to access new opportunities and experiences. It also said that it needs to start thinking outside of the written assessments and plans and apply the information gathered in order to provide a lifestyle that supports people to fulfil their potential. Daily routines and activity plans were discussed which included attending various day centres and clubs in the local community. People regularly go out and enjoy the local community amenities by visiting pubs, restaurants, leisure centre, shops, and cinemas. Some people attend college and are involved in voluntary work. During our visit people were at college and a group of people went swimming. People told us that they were going to a local club that evening to a disco, everyone was excited about going which we were told is a regular event and very popular. The deputy managers told us that they have plans for outings further a field when the warmer weather permits and would like to take people on vacation. They discussed several initiatives for the future including, creating links with the local community including schools. The home wants to organise events where families and friends are invited to attend, including coffee mornings, barbeques and garden fetes. The people living in the home produce individual newsletters which they send to their families and friends. It provides information about what they have done, the latest news about staff, forthcoming events and special features. Useful information is shared by having several notice boards throughout the home notifying people of any news, current events, dates for your diary and an activity programmes. Lounges in the home provide good entertainment systems including televisions, videos, DVD players and musical systems. The home operates an open door policy for visitors and people are able to see visitors in the privacy of their own rooms and there are several semi-private Downside House DS0000072307.V373025.R01.S.doc Version 5.2 Page 14 seating areas around the home and in the gardens. Many of the people in the home have friends over to spend time with them. The size and layout of the dining rooms makes it possible for everyone to enjoy the social advantages of dining together, however people can choose to receive their meals in their rooms if they prefer. The dining rooms are light and spacious with the tables attractively laid. Staff members supported people that required assistance with eating their meals in a respectful sensitive manner. Staff sat at the same level and assisted them without rushing. People make their own choices at mealtimes with the support of the staff. The menus, which they have produced, offer a varied healthy diet plan. Alternatives were also made available and flexibility in meals was evident, people are encouraged to help prepare the meals. Staff in the home are mindful of educating and assisting people in maintaining a healthy balanced diet and peoples weight is monitored on a monthly basis. The kitchen was clean, tidy and well equipped. The stores, fridge and freezer had a good supply of food. People living in the home are involved in the weekly shopping and use local amenities for their food supplies. A recent visit from the Environmental Health Department awarded the home 5 stars. Downside House DS0000072307.V373025.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service had good systems for meeting and monitoring individuals’ physical, emotional and health care needs. There are safe systems of practice in receiving, storing, administering, and disposing of drugs. EVIDENCE: The care plans we looked at gave clear information about individual needs both physically and emotionally. Staff were able to demonstrate that great attention to detail had been made, including their role as key worker. Staff support and encourage people to express their preferences when purchasing clothes, toiletries and having their hair done. Plans also tell staff whether people prefer male or female carers when receiving personal care and what they like to be called. Downside House DS0000072307.V373025.R01.S.doc Version 5.2 Page 16 All bedrooms are en suite in both homes providing individual privacy. One person in the home requested that a bath was put in his en suite in addition to the shower and the home made sure that this was done. Health Care needs are detailed in the Care Files. Records of visits to the General Practitioner (GP) and the outcomes are recorded. Specialist referrals and visits to other health professionals including, consultants, Chiropractors and Dentists were seen; to help ensure that peoples identified needs are being monitored and met. The deputy managers explained that peoples healthcare needs are closely monitored in consultation with primary health care services and that access to health screening is undertaken. The home has monthly recording books so that they have a quick reference guide and background history for individuals. Information includes a daily account, fluid and nutritional intake and a record of any seizures. Short term care books are also available for example when a person is on antibiotics for a chest infection. All staff have had first aid training. Policies and procedures for receiving, storing, administering and disposing of medications was examined and correct. There were photographs of each person on their medication charts to help ensure that medication was dispensed to the correct person. Medication fact sheets are available and tell staff how people like to take their medicine. The administration charts were legible and continuity of administration was shown with a signature from the person dispensing. Up to date records evidenced that medication received in the home and medication being returned to the local pharmacy was being followed correctly. Staff training records evidenced that staff had received competency training from the local pharmacist, which is updated annually. The local pharmacy provides six-monthly medication reviews. Downside House DS0000072307.V373025.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are policies and procedures in place to manage complaints and people should be confident that their concerns will be listened to and acted upon. There are good arrangements in place for staff training and awareness of protecting vulnerable adults so that people living in the home are further protected from abuse. EVIDENCE: People living in the home and families have information provided in the Service User Guide on how to make a complaint and voice concerns; this information is also on display in the reception area. The deputy managers told us that any concerns raised by people are dealt with immediately wherever possible; information of the outcome is cascaded down to the staff, through hand over and recorded in the care files. Two people told us that they knew who to speak to if they were not happy but said that they didn’t know how to make a complaint. One person told us, Sometimes the home takes too long to respond to any requests. The manager told us that the staff felt that in some instances communication had been lapse and that they were working hard to improve communication so that people and visitors to the home feel that they are listened to and supported. Downside House DS0000072307.V373025.R01.S.doc Version 5.2 Page 18 People living in the home and their families will be invited to the six-monthly reviews, which will give them the opportunity to discuss any concerns they may have. Some people living in the home would not be able to complain due to their learning and physical disabilities however staff have worked hard to develop an awareness to know that a person may not be happy either through facial and vocal expression or changes in their behaviour. We were told that the home actively promotes staff training and education in the protection of vulnerable adults on induction and on an annual basis the staff receive an update. We spoke with staff who confirmed that they had received this training and they were able to demonstrate its effectiveness when discussing the content of the training. A number of staff are also enrolled on the National Vocational Qualification in care award, and a component of the award addresses issues around the topic of the protection of vulnerable adults from abuse. There are policies and procedures in whistle blowing as well as a range of guidance information on the topic of protection of vulnerable adults from abuse. The availability of this information should increase staff awareness and understanding of their role in protecting the people in their care. The home maintains records of accidents and incidents. It also notifies us of any significant event which occurs within the home. Downside House DS0000072307.V373025.R01.S.doc Version 5.2 Page 19 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, 25, 26, 27, 28, 29, 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is clean, comfortable, well decorated, furnished and equipped. It provides a safe, peaceful and well-maintained environment for everyone. The bedrooms, communal rooms and facilities are suitable and well presented for their purpose and meet the needs of people living in the home. EVIDENCE: Lavender has been completely renovated and re-decorated to a very good standard. Primrose is purpose built and as such it is fully accessible with a number of aids and adaptations throughout the premises to enable physically disabled people to maximise their independence. This includes wide corridors and pathways, passenger lifts, ceiling hoists, specialised bathing facilities, grab rails and assisted toilet facilities. Downside House DS0000072307.V373025.R01.S.doc Version 5.2 Page 20 The passenger lift is not easy to use independently for some people in the home which means people may have to wait to go to their rooms if staff are otherwise engaged. We were told that this is being looked at in order to find an alternative solution The home has car parking to the front and a safe secluded garden with a lawn, patio area with seating for people to use. Staff told us about plans for the gardens in spring with regards to planting boarders, baskets and planters with the people living there. We walked around both homes and viewed some of the bedrooms and communal areas including the dining rooms, lounges and bathrooms. Room sizes are spacious for their stated purposes, particularly the lounges and bedrooms. Bedrooms have en suite facilities provided and communal bathing areas, showers and toilet facilities are located throughout the home. People had been supported to personalise their bedrooms with pictures, bedding and memorabilia and they are able to bring items of furniture should they wish. Rooms are lockable so that they can maintain their privacy and keep their personal possessions secure; people are asked if they would like a key to their rooms on admission. All rooms had profiling beds where needed, and good quality matching bedroom suites, lounge chairs and a small table. Various lounge areas allow for people to be seated together enjoying the entertainment systems on offer. All areas of the home were tastefully decorated, clean and well maintained. Attention has been given to ensure that all areas are homely There are good arrangements in place for general repairs and maintenance. Downside House DS0000072307.V373025.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The relationships between staff and people living in the home are good and create a warm positive environment to live in. People are supported and protected by the homes recruitment policy. The people are cared for by skilled staff that are trained, supported and supervised by management. EVIDENCE: As mentioned previously the home has been registered for six months. During this time the manager has recruited a full compliment of staff with a range of skills and expertise. During our visit we saw that staff are developing and growing into a stable team that are dedicated to caring for the people living in the home. Downside House DS0000072307.V373025.R01.S.doc Version 5.2 Page 22 We spent time throughout the day observing staff carrying out their duties and assisting individuals. Staff were respectful, warm in manner, good humoured and sensitive towards the people within a relaxed homely environment. Morale in the home appeared good with the staff working well together. A sample of staff recruitment records were looked at and showed us that the home follows a good recruitment procedure. This will help ensure that the right people are employed to work at the home, and people living in the home will be further protected. Records contained completed application forms with a full employment history, two written references and Criminal Records Bureau (CRB) disclosures. There is an induction programme, which covers all mandatory training, including Fire, Manual Handling, Health and Safety and the Protection of Vulnerable Adults. The home has a mentor system where all new staff are linked with and shadow a senior staff member during each shift to enable continuity and continued training throughout the induction process. The home provides the staff at the home with training and development opportunities tailored to individual needs. The manager and staff are conscientious in attending training relevant to the needs of the people they are caring for. Courses are relevant to the roles they perform in order to understand the needs of individuals and to keep them up to date with current practice. To date the team has focused on training in Autism Awareness, Managing Epilepsy and Non Violent Crisis Intervention. At present 37 of staff hold an NVQ qualification, the home supports staff with NVQ training and the enrolling programme continues. Downside House DS0000072307.V373025.R01.S.doc Version 5.2 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Peoples’ needs and best interests are central to the management approach in the home. People benefit from a well-managed and safe environment. There are good systems in place to protect and safeguard the people living in the home. EVIDENCE: During our visit we spent a lot of time speaking with the deputy managers who both consistently demonstrated good leadership skills within their roles and management that relates to the aims and purpose of the home. Downside House DS0000072307.V373025.R01.S.doc Version 5.2 Page 24 Both deputies have NVQ3 and are working towards achieving NVQ4. Combined they have thirteen years experience in care including older people, supported living and people with learning and physical disabilities. Both deputies are embracing their new roles within the management team and are enjoying the challenges and experiences within those roles. Both feel that it is a case of putting the theory they have learnt into practice in order to develop further. They told us that they were always supported by the manager, He has a mind full of knowledge and knows everything, if he doesn’t know something he will find out for us. At present the deputies meet with the manager 2-3 times per week and staff meetings are held bi monthly. The management encourages innovation within staff teams and ideas that are generated are respected and actioned, which demonstrates an open and inclusive atmosphere. The home is currently looking at ways of quality assuring the services they provide and this will be looked at during our next visit to the home. There are recording systems in place to support Health and Safety within the home, which are being used consistently. Fridge, freezer and hot water temperature checks are carried out. Downside House DS0000072307.V373025.R01.S.doc Version 5.2 Page 25 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 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 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 X 32 3 33 3 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 X X 3 x LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 X 3 X X 3 x Downside House DS0000072307.V373025.R01.S.doc Version 5.2 Page 26 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Downside House DS0000072307.V373025.R01.S.doc Version 5.2 Page 27 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. 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