Care Home: Elizabeth House

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What the care home does well There are good, clear assessments of need for individuals. There are well-written support plans with risk assessments and clear monitoring charts. There are good arrangements for support to enable service users to participate in activities in the community as independently as possible. Individuals are supported well to go on a holiday of their choice. The people living in the home are supported to maintain contact with their families. People are supported well to manage their own health care.The people living in the home are supported to express their views and concerns and say what they want to do. They are also well supported to develop their confidence and skills in social situations. There is a good staff-training programme to support individuals with their health and social needs. There is an effective quality assurance system in the home. Comments on how to improve the quality of the service are acknowledged and acted upon. The homeowners are clear about the aims of the home. What has improved since the last inspection? The owners have improved the organisation of the staff files. All information was easily accessible. All necessary safety checks have been made and the recruitment process is very good. The owners have reviewed the staff skills. They have developed a whole new department of three staff and an activities workshop to provide a variety of occupational and creative activities for all the people who live there. All staff receive formal supervision to make sure that there are good lines of communication in the home and consistency in care practice. CARE HOME ADULTS 18-65 Elizabeth House 68 Island Road Upstreet Canterbury Kent CT3 4DD Lead Inspector Julie Sumner Unannounced Inspection 24th July 2008 10:30 Elizabeth House DS0000023386.V367428.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 Elizabeth House DS0000023386.V367428.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. Elizabeth House DS0000023386.V367428.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Elizabeth House Address 68 Island Road Upstreet Canterbury Kent CT3 4DD 01227 860516 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) rodtarry@dementia-care.com Mr Rodney Gilbert Tarry Mrs Roberta Dorothy Cooper Tarry Care Home 18 Category(ies) of Past or present alcohol dependence (0), registration, with number Dementia (0) of places Elizabeth House DS0000023386.V367428.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Past or present alcohol dependence (A) 2. Dementia (DE). The maximum number of service users to be accommodated is 18. Date of last inspection 27th July 2007 Brief Description of the Service: Elizabeth House provides accommodation and personal care for up to 18 people between the age of 18 and 65 who have dementia and past or present alcohol dependence. The mission statement for the home is: “The Elizabeth House team is committed to providing outstanding support, care and rehabilitation facilities for adults aged between 18 and 65 with dementia and related mental health conditions, specialising in Korsakovs syndrome and alcohol-related dementia. We achieve this through an holistic social care model, encouraging and enabling physical activity, mental stimulation and life skills development in order to empower our clients to make healthier choices for their future.” Elizabeth House is an older property and provides accommodation over two floors. All people living in the home have single rooms, except two residents who have chosen to share. People share a lounge/dining room and smoking room. There is an attractive patio garden to the rear of the property. The home is close to the centre of the small village of Upstreet near Canterbury. There is a general store within walking distance of the home. The nearest town is some miles away, but can be reached by bus. Residents prefer to use the home’s people carrier and driver to make their journeys. Elizabeth House DS0000023386.V367428.R01.S.doc Version 5.2 Page 5 Mr and Mrs Tarry own the service and are also actively involved in the day-today running of the home. The current fees for the service at the time of the visit range from £367.82 to £525.00. The home provides very clear information detailing what the fees cover and what is not included. Information on the home’s services and the CSCI reports for prospective service users are included in the statement of purpose and service user guide. Elizabeth House DS0000023386.V367428.R01.S.doc Version 5.2 Page 6 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. This report is based on information received about Elizabeth House including an annual quality assurance assessment (AQAA) completed by the registered manager and a visit to the home lasting around 6 hours. The visit was unannounced, which means that the people living in the home, staff and homeowners did not know that we (the commission for social care inspection CSCI) were calling. Information was gathered for this inspection in a variety of ways throughout the year since the last inspection visit and during this visit to the home. The visit included talking with people living in the home, the manager and staff. General observations were made during the day of how people are supported. There was a tour of the building and various records were inspected. The people living in Elizabeth House were able to participate in the inspection by talking about their lifestyle and showing us what they were doing. The requirement and recommendation from the previous inspection visit have been acted on. No requirements or recommendations were necessary at this visit. What the service does well: There are good, clear assessments of need for individuals. There are well-written support plans with risk assessments and clear monitoring charts. There are good arrangements for support to enable service users to participate in activities in the community as independently as possible. Individuals are supported well to go on a holiday of their choice. The people living in the home are supported to maintain contact with their families. People are supported well to manage their own health care. Elizabeth House DS0000023386.V367428.R01.S.doc Version 5.2 Page 7 The people living in the home are supported to express their views and concerns and say what they want to do. They are also well supported to develop their confidence and skills in social situations. There is a good staff-training programme to support individuals with their health and social needs. There is an effective quality assurance system in the home. Comments on how to improve the quality of the service are acknowledged and acted upon. The homeowners are clear about the aims of 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. Elizabeth House DS0000023386.V367428.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 Elizabeth House DS0000023386.V367428.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): 1, 2 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. No one is admitted to the home until a full needs assessment has been made. EVIDENCE: The home produces a good website. The home have designed a new statement of purpose, service user guide and new style contract and all this documentation very clearly sets out what to expect from Elizabeth House. The AQAA states clearly what the admission process is. The AQAA states they plan to improve the web site to make it clear to visitors exactly what they are doing at Elizabeth House. Two people have moved to the home in the last few days. They said they have what they need here. There is a three monthly “getting to know us” period. The home do not accept people for respite care as they consider it too disruptive for all concerned. Initial assessments are carried out by the owners, prior to moving in, to decide whether the home can meet a person’s needs. The assessment continues while the people at Elizabeth house get to know each other and this forms the basis of the person’s support and care plan. Elizabeth House DS0000023386.V367428.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, 9 People who use the service experience excellent quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The care plans are working documents and are reviewed regularly involving the person and their representative. Any limitations on freedom and choice are always in the person’s best interests. EVIDENCE: Each person has a written plan of support and care. The format of the plan has been designed by the home to fit with the service provided. Each plan is written in with the individual and they agree the contents. One of the staff explained that they need to go through the care plan over and over again with each person who has short-term memory loss. This enables each person to participate and be aware of the contents. Two plans were looked at. There is clear information in the assessment, which forms the basis of the plan. This includes the person’s past health history, level of understanding and memory, personal care needs and social needs and various other areas of care or Elizabeth House DS0000023386.V367428.R01.S.doc Version 5.2 Page 11 support need. A new active therapy assessment form has been designed by the activities coordinator to be incorporated into the care plan. People are invited to attend the monthly client’s meetings to discuss any issues or ideas for the service provided in the home. The minutes of the last meeting were looked at and showed good attendance. Plans that had been made at the meeting from the suggestions of the people living in the home were written in the minutes and had evidently been acted on. For example there was some discussion around decorating the home and it was agreed that the hall way needed painting. This was being carried out by one of the people living in the home and one of the staff during the inspection visit. All people living in the home are free to do what they please within reason. Some people manage their personal allowance; others have their monies managed either by a relative, or Mrs Tarry, one of the registered owners. Records are kept of all transactions made with or on behalf of individuals. All people living in the home are encouraged to take reasonable and responsible risks as part of their skill development and reintroduction to independent living. The home assist people in developing their independence through risk assessment and agreeing the level of support needed, which is then gradually withdrawn. The manager said that if a person wants to leave the premises unescorted then stringent risk assessments are carried out first. Elizabeth House DS0000023386.V367428.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, 17 People who use the service experience excellent quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The people living in the home are able to enjoy and full and stimulating lifestyle with a variety of options to choose from. The service actively supports the people living in the home to be independent and involved in all areas of daily living. EVIDENCE: There is a new activities department. Three staff have been employed to support individuals to develop their interests and lifestyle. One of the new team is a trained carpenter and general handyman. Individuals assist him in tasks around the home, which are risk assessed first. Recently people have assisted fixing new handrails, simple plumbing, building the new polycarbonate greenhouse, painting and decorating. Elizabeth House DS0000023386.V367428.R01.S.doc Version 5.2 Page 13 The other team members have expertise in gardening, arts and crafts, general confidence building and other therapeutic activities such as music therapy, assisting and enabling the clients in joining the local gym and hydrotherapy sessions at a nearby pool. Staff spoke about the activities that have been arranged. There is a weekly “debating society” for individuals to express their views on current affairs which has developed the peoples’ interest in what is going on around them. There is a weekly “Book club”, where either a short story, or adventure novel is read and discussed, and some readings where the whole group reads a chapter/passage. The weekly music session was being held on the day of the visit. One of the activity staff plans this before by finding out what artist or group the people joining in with this session want to hear. She then researches the music compiles a CD and they listen, sing and discuss. People were also gardening during the visit. It was a very hot day and others were sitting in the shade. There was a generally relaxed atmosphere. The owners were sitting with the people and there were various conversations. The home produces a newsletter that includes all the outside activities that people have participated in. In June a group of people visited Walmer Castle had a Caribbean barbeque, went to Hoath flower festival, had lunch on Margate beach and played mini golf in Herne Bay. Some of the people living here went on holiday to Butlins in Minehead. An annual holiday is included in the homes fees. The company minibus provides transport for all the people living in the home to access appointments, therapy sessions, adult education and outings. Staff spoke about supporting the people living in the home to maintain contact with family and friends and about rebuilding relationships. Family contact details were in each support and care plan. The manager said interaction and opinions of relatives and friends are encouraged. Records are kept of contact made. There is a computer connected to the internet in the lounge area, for computer lessons, for the people living in the home to write letters, and to use the internet for information. Visitors are encouraged to join in with the debates and other activities when they visit. The staff said friendships are encouraged in the local community. One of the people living in the home visits somebody locally to exchange magazines. The home has a community rota for people to take an active and productive part in the running of the home. Individuals assist with meal preparation and cleaning up afterwards which are on this rota. Some of the fruit and vegetables that are used are grown in the owners’ smallholding and allotment. Meals are balanced and nutritious starting with a cooked breakfast, main cooked lunch and cooked supper. One person commented in the recent client meeting that “the food is unbelievably good.” There are lots of choices of what Elizabeth House DS0000023386.V367428.R01.S.doc Version 5.2 Page 14 and when to eat. If a person goes out over a mealtime their meal is kept for them, and re-heated on their return. Meals and snacks are very flexible. On outings people either eat at cafes and restaurants or take a packed lunch from the home. People spoke of their recent evening outing to a Chinese restaurant which they enjoyed and some photos of this were on display. Elizabeth House DS0000023386.V367428.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 People who use the service experience excellent quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People living in the home receive effective personal and healthcare support using a person centred approach. EVIDENCE: Each person’s personal and health care needs are assessed when they move into the home and their support needs are recorded. A medical history is compiled to form the basis of the health care plan. The home has a hoist, an assisted bath and a chair lift. And all other aids are provided following the assessment. Chiropody, aromatherapy and hairdressing are all provided by professionals who visit the home on a regular basis. The continence nurse also provides advice and equipment for some individuals. The people living in the home are supported to access the services from health care professionals including the dentist, GP, ophthalmology, hydrotherapy and addiction counselling. The home provides transport to and from health care appointments. Staff support each person to attend appointments and often Elizabeth House DS0000023386.V367428.R01.S.doc Version 5.2 Page 16 another activity is included in the trip out, as part of ordinary living. The minibus has a hydraulic lift to assist anyone with mobility difficulties. Staff were observed to respect individuals’ preferences. Records viewed indicated that staff are aware of what to look out for if a person’s health deteriorates. The staff also explained how important it is to monitor the weight of individuals to indicate their state of health. Weight records are updated monthly and indicate very quickly any changes so that suitable action can be taken. One of the staff went through the medication during the visit. Boot’s pharmacist carries out annual medication reviews. Medication storage was viewed and was well organised. Medication administration charts were clearly written. One of the owners, Mrs Tarry, checks the medication in and out of the home. She also makes sure that all medication has been given correctly and notices and acts on any errors. All staff receive training in giving medication before being able to do this without supervision. One of the newer staff was being supervised by the owner giving the lunchtime medication out. The people who currently live in the home need assistance to take their medication. Assessments have been carried out and people do as much for themselves as possible. One person can manage an injection himself, only needing observation from staff to support. Elizabeth House DS0000023386.V367428.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 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home has an open culture that allows the people living there to express their views and concerns in a safe and understanding environment. The policies and procedures in the home protect the individuals living there. EVIDENCE: People were observed discussing different areas of interest or concern with the owners. The owners said that concerns are usually dealt with straight away. They said there is a complaints procedure and any complaints made are recorded in the complaints log. The complaints procedure is on display in the entrance to Elizabeth House. All the people living in the home are made aware of how to complain about the service. All staff members are made aware during their induction, and within the policies and procedures, of the complaints procedure, who to complain to and how. The owners are open with CSCI and report any concerns that need clarification. There was a complaint from an ex-member of staff and this has been dealt with appropriately. There is a “whistle-blowing” policy, abuse and harm policy, and intervention policy. All staff have CRB disclosures, with POVA clearance. All staff are trained to manage challenging behaviour and have attended training in safeguarding adults. Some of the people were spoken to during the day. They said they had no complaints, staff were kind and they could talk to them and they feel safe in the home. Elizabeth House DS0000023386.V367428.R01.S.doc Version 5.2 Page 18 Elizabeth House DS0000023386.V367428.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, 30 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home is well maintained and provides a physical environment that is appropriate to the specific needs of the people who live there. EVIDENCE: A tour of parts of the home was carried out firstly with the one of the owners and then with a member of staff. The manager carries out the audits of the home and plans which areas need to be redecorated and if new equipment is needed. Meetings are also held with the people living in the home and during this there are also discussions about improvements to the building. It was also agreed that the dining room should be refurbished. They all chose the colours and it has now been decorated. At the following meeting they said the hallway needed brightening up. One of the people living in the home and one of the staff were decorating the hallway. The activities staff are working with individuals to paint and create new pictures to put on the walls. Some of these pictures have been put up. Elizabeth House DS0000023386.V367428.R01.S.doc Version 5.2 Page 20 There is a household maintenance task book where people add what needs to be done. One of the activities staff carries out some of the maintenance work with the people living in the home where possible. The owners talked about some of the more major plans for refurbishment of the bathroom areas and one of the office areas in the main house. Individuals agreed to their bedrooms being shown during the tour. They are personalised and some people have tea and coffee making facilities in their bedrooms. The new converted Art and Crafts block offers the opportunity for individuals to discover their artistic talents. They can work alone or in a group, on a single or joint project, in a range of mediums. Some of the current works were seen and it looked like the opportunity to be creative was being met with enthusiasm and ability. The people living in the home were enjoying the garden and sitting outside under the parasols. There is a new paved garden on one level with raised borders for easy access. A new polycarbonate greenhouse has been constructed. The gardens have allocated areas for each client that enjoys gardening. There is a good-sized laundry with washing machines and tumble drier suitable for the needs of the home. Staff have attended infection control training and protective equipment is provided. Elizabeth House DS0000023386.V367428.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, 34, 35 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People living in the home have confidence in the staff that care for and support them. The service ensures that all staff receive relevant training that is focussed on creating improved outcomes for the people living in the home. EVIDENCE: The attitude of the staff team is that they work “with” the people who live in the home instead of “for” them. Staff have clearly defined roles and they talked about what they do. The duty rota is flexible and shifts are worked around the activities planned. The activities staff work some of the weekends and also during the evening so that people can go out. The home has a thorough recruitment process, including 2 references, Criminal records bureau (CRB) and protection of vulnerable adults list (POVA) checks, relevant identification checks. Two interviews are held and the candidates reaction to the people living in the home is monitored. The owners get the opinions from the people living in the home and the staff on duty after the candidate has left. Staff then have a probationary period of time while Elizabeth House DS0000023386.V367428.R01.S.doc Version 5.2 Page 22 everyone gets to know each other and the member of staff decides whether this is the right job for them. New staff have induction training for a week before they start working with the people living in the home. Then they continue with the Skills for Care induction pack. Some of the records were looked at. The home have just bought a Skills for Care training package also. The training records were also looked at. All the records and certificates are kept in folders and are well organised. A good range of training is provided. Recent training includes: working with people with epilepsy, diabetes and insulin administration, managing challenging behaviour and safeguarding vulnerable adults. The manager has one-to-one meetings with the staff and also supervises their work to make sure they understand and follow the procedures in the home. Staff meetings are held monthly and staff said they discuss ideas with each other as they come up. The staff were observed to be motivated and did everything that they said they did. Elizabeth House DS0000023386.V367428.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, 42 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The owners continuously improve the service and provide an increased quality of life for people with a strong focus on equality and diversity issues. There is a strong ethos of being open and transparent in all areas of the running of the home. EVIDENCE: Mrs Tarry has attained her NVQ level 4 in Health and Social care, and the Registered Managers award in March 2006. She also has 22 years experience in caring and management within the caring “industry”. She manages the staff, assessment and admission of new clients, policies and procedures, induction of new members of staff, the diary, the client’s personal allowance, ongoing supervision and appraisals and staff rotas. Mr Tarry has also 22 years experience in caring and management, he manages the accounts, the wages, Elizabeth House DS0000023386.V367428.R01.S.doc Version 5.2 Page 24 “estate management” and every day “trouble shooting”. He also manages the assessment and admission of new clients with Mrs Tarry. Mr and Mrs Tarry live on the same site as the home, therefore are on call at any time. They both work daily and explained that they are in close touch with any progress and events in the home. A comment in a recent quality monitoring survey: “your home seems to be well run you are in touch with the home at all times and understand what is going on.” The owners have engaged with people who have expressed a desire to move into the home from different cultures. They were observed to take into account the diverse needs of the people living in the home. The service is tailored to meet each person’s needs. Documentation was clear and up to date. People’s religious, spiritual and dietary needs are accommodated. There is a quality monitoring system in the home. Mrs Tarry had recently received the latest questionnaire responses from people living in the home, relatives, visiting professionals and staff. Some of the questionnaires were looked at. All the comments viewed were positive. There were some comments made where some minor improvements could be made and Mrs Tarry said she would incorporate them into the homes business and development plan. All building and equipment servicing checks are made. There is a fire risk assessment and all staff have been trained in fire safety. Drills and tests are carried out to make sure staff know what to do and the people living in the home are supported to know what to do. The kitchen staff have training in food handling and the home uses the Department of Health guide ‘Essential Steps’ to assess their current infection control management. All staff files looked at had up to date training in health and safety and other training that is needed by law to work safely. Elizabeth House DS0000023386.V367428.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 3 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 4 4 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 4 15 3 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 3 X 3 X 3 X X 3 X Elizabeth House DS0000023386.V367428.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 Elizabeth House DS0000023386.V367428.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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