Care Home: Gateway House

What the care home does well This home consistently meets the key national minimum standards ensuring positive outcomes for the people who live there.Each person living in the home has an individual care plan which clearly details the levels of care and support required, along with how they prefer the support to be provided. They have been compiled with each persons input as appropriate. Detailed risk assessments are also in place that ensure that people are able to live the lives of their choosing within a safe framework. The organisation provides a day service as an alternative to local social service day centres and people are supported to access whichever service provision they have chosen. Where people choose not to attend a day service, they are supported to access activities, hobbies and leisure pursuits as they wish. Contact with relatives and friends is promoted by the home, and is seen as being of paramount importance where applicable. A healthy diet is promoted within the home. People are supported with menu planning, and preparing their breakfast and packed lunches. Good stocks of fresh, frozen and processed foods were available in the home. People`s personal support and care needs were clearly documented, as were their health needs, along with evidence to confirm that these are addressed appropriately. The people who live in this home rely on the staff to manage their medication for them. This is done on an individual basis, and procedures and practices appeared safe during the inspection. The home has a complaints procedure in place. Relatives and people living in the home are aware of either how to complain, or who to speak to should they need to. The recording of complaints received was appropriate, as was the reporting of the outcomes of the investigations relating to these. A policy on the protection of vulnerable adults is also in place in the home. Staff have received training in this area, and were aware of their responsibilities should abuse be alleged or suspected. The home was nicely decorated and furnished. It was also clean and hygienic with no unpleasant or offensive odours apparent. The home employs sufficient staff to meet the needs of the people living there. A comprehensive training package is provided that ensures that each member of staff is able to effectively meet the needs of the people living in the home. Staff recruitment procedures ensure that people are safeguarded. The home is managed by a competent and experienced manager. Health and safety is managed appropriately.Gateway HouseDS0000004288.V360536.R01.S.docVersion 5.2Page 7 What has improved since the last inspection? Work has been undertaken since the last inspection to meet the requirements made. Some of the people living in the home have been issued with contracts that detail their terms of residency, the home is still working on consent issues with some individuals. Regulation 26 visits to the service by a representative of the provider have recommenced. What the care home could do better: Although peoples support plans are comprehensive and detailed, records indicated that the individual care plans required reviewing in some instances. This was discussed with the manager during the inspection who undertook to ensure that this was addressed. The building remains a problem. It is old and large and difficult to get around for people who have any mobility problems. Although the flat on the third floor has only two people living in it, in the rest of the house people have to live in a larger group and have limited privacy. The kitchen is very small and it is difficult to include people in its use, especially when preparing the main meal of the day. Plans are developing to replace the building with a modern and more person centred care service for current residents and this is positive. CARE HOME ADULTS 18-65 Gateway House 14 Bilton Road Rugby Warwickshire CV22 7AN Lead Inspector Justine Poulton Unannounced Inspection 14th February 2008 09:00 Gateway House DS0000004288.V360536.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 Gateway House DS0000004288.V360536.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. Gateway House DS0000004288.V360536.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Gateway House Address 14 Bilton Road Rugby Warwickshire CV22 7AN 01788 573 248 01788 573410 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) New Directions (Rugby) Ltd Mrs Emma Daffey Care Home 15 Category(ies) of Learning disability (15) registration, with number of places Gateway House DS0000004288.V360536.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27th June 2006 Brief Description of the Service: Gateway House is a large detached Victorian town house that is registered to provide residential care and support for up to 15 younger adults with learning disabilities. At the time of this inspection there were 10 people in residence. The service also has one respite bed available. There are 11 single bedrooms including the respite bedroom in the main house. There is also a flat on the top floor of the house that can accommodate up to 3 people in single rooms. The communal areas of the house are on the ground floor, and consist of a large comfortable lounge, a quieter music / games room, large dining room and small kitchen. The service is operated by New Directions and is one of four separate establishments and a domiciliary care service in Rugby. Gateway House DS0000004288.V360536.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This inspection was carried out to establish the outcomes for people living in this home, and to confirm whether they are protected from harm. Identified key standards were looked at, along with a review of the organisations progress towards meeting any requirements made at the previous inspection of this service. The pre fieldwork inspection record was completed, as well as a site visit to the home, during which time staff, people living in the home and the manager were spoken with. A completed annual quality assurance assessment was received from the service prior to the inspection along with fifteen completed surveys from relatives, people using the service and associated healthcare professionals. Two people were identified for close examination by reading their care plans, risk assessments, daily records and other relevant information. This is part of a process known as ‘case tracking’ where evidence is matched to outcomes for service users. Records, policies and procedures were examined and the environment was looked at. An ‘expert by experience’ participated in this inspection. This is a person who receives a care service themselves and also has a learning disability, who visits a service with an inspector to help them get a picture of what it is like to live in, or use the service. The expert by experience takes the opportunity on the inspection visit to talk to the people who live there, visiting families and staff. Their findings are also included in this report and used as evidence when deciding on the quality of service provided at the home. All of the people living in or visiting the home for respite were at home for all or part of the inspection. The inspector would like to thank the service users, manager and staff for their hospitality and co-operation during the inspection. What the service does well: This home consistently meets the key national minimum standards ensuring positive outcomes for the people who live there. Gateway House DS0000004288.V360536.R01.S.doc Version 5.2 Page 6 Each person living in the home has an individual care plan which clearly details the levels of care and support required, along with how they prefer the support to be provided. They have been compiled with each persons input as appropriate. Detailed risk assessments are also in place that ensure that people are able to live the lives of their choosing within a safe framework. The organisation provides a day service as an alternative to local social service day centres and people are supported to access whichever service provision they have chosen. Where people choose not to attend a day service, they are supported to access activities, hobbies and leisure pursuits as they wish. Contact with relatives and friends is promoted by the home, and is seen as being of paramount importance where applicable. A healthy diet is promoted within the home. People are supported with menu planning, and preparing their breakfast and packed lunches. Good stocks of fresh, frozen and processed foods were available in the home. People’s personal support and care needs were clearly documented, as were their health needs, along with evidence to confirm that these are addressed appropriately. The people who live in this home rely on the staff to manage their medication for them. This is done on an individual basis, and procedures and practices appeared safe during the inspection. The home has a complaints procedure in place. Relatives and people living in the home are aware of either how to complain, or who to speak to should they need to. The recording of complaints received was appropriate, as was the reporting of the outcomes of the investigations relating to these. A policy on the protection of vulnerable adults is also in place in the home. Staff have received training in this area, and were aware of their responsibilities should abuse be alleged or suspected. The home was nicely decorated and furnished. It was also clean and hygienic with no unpleasant or offensive odours apparent. The home employs sufficient staff to meet the needs of the people living there. A comprehensive training package is provided that ensures that each member of staff is able to effectively meet the needs of the people living in the home. Staff recruitment procedures ensure that people are safeguarded. The home is managed by a competent and experienced manager. Health and safety is managed appropriately. Gateway House DS0000004288.V360536.R01.S.doc Version 5.2 Page 7 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. Gateway House DS0000004288.V360536.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 Gateway House DS0000004288.V360536.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): 5 Quality in this outcome area is good. Staff continue to have the skills, knowledge and understanding necessary for the home to meet the assessed needs of the people that live there. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has had no new admissions since the last inspection in June 2006 therefore this outcome group was not looked at on this occasion. Contracts of terms and conditions were available within some peoples files. It was advised that the home is still working on consent issues with one individual. On previous occasions it has been rated as good. This rating still stands. Gateway House DS0000004288.V360536.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 Quality in this outcome area is good. A clear, consistent care planning system provides staff with the information they need to satisfactorily meet people’s individual needs. They ensure that people are able to make decisions about their lives as appropriate. People are supported to take reasonable risks based on effective risk management strategies that are agreed and recorded in individual care plans. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Each person that lives in the home has a written support plan. Two of these were looked at as part of the case tracking process. Each support plan was divided in to individual care plans. These were numbered for ease of understanding and recording. Each separate one had an objective, details of Gateway House DS0000004288.V360536.R01.S.doc Version 5.2 Page 11 whose responsibility it is to support this objective, the aims and the actions necessary to assist each person with meeting the objective. Areas covered by the care plans included communication, finance management, hobbies and interests, relationships and behaviour. The information contained within the care plans was detailed and informative and ensured that staff were able to meet people’s needs effectively. It was noted that some of the care plans required reviewing. This was discussed with the manager during the inspection who undertook to action this. Records confirmed that relatives and other key parties were invited to attend reviews. In addition to the individual care plans, risk assessments were also available in the support plans looked at. These were comprehensive in their detail and covered such risks as road safety, bathing, kitchen safety, money management, relationships and community access. Records confirmed that the risk assessments looked at had all been reviewed within the last 12 months. Throughout the inspection it was apparent that people were being supported to make decisions for themselves. Two people have a close relationship and are able to choose whether they wish to spend time on their own together. In conversation with the expert by experience people also said that they were able to choose their drinks and meals, what to watch on the television and what activities they wish to participate in. One person also showed the expert the hairstyle that they had chosen ready for their next visit to the hairdressers. People also said that they were happy living with their friends, but were unhappy living with people that they did not get on with. Unfortunately, due to the current size and layout of the home this is an area that people are unable to exercise choice over. Gateway House DS0000004288.V360536.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 Quality in this outcome area is good. The people who live in home have the opportunity to live ordinary and meaningful lives within the community in which they live. Support to maintain and develop family links and friendships is available. A varied selection of food is available that meets service user’s dietary needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: New Directions provides a day service for people who wish to attend. The majority of people who live in the home have chosen to attend this service on either a full or part time basis rather than the local authority day service. Gateway House DS0000004288.V360536.R01.S.doc Version 5.2 Page 13 One person spoken with said that she works in a local coffee shop twice a week and attends a college in Coventry, which she enjoys. This person also said that she enjoys visiting the local library on a regular basis and attends church every week. In addition people are actively supported to participate in their hobbies and interests. There is a games / music room in the home which has a pool table, various board games and a small selection of instruments available for people to use. At the time of the inspection the homes computer was also set up in this room, and although staff spoken with said that it was the office computer, and not for use by the people living in the home, it was pleasing to see that staff were actually supporting people to use it to look at photographs and play games during the inspection. As well as the in house activities that are available for people, visits to local pubs, cinemas, bowling, shopping trips and other community based leisure facilities are routinely offered on a regular basis. People are also actively supported with choosing, planning and going on holiday. Information was available to confirm that relationships between the people living in the home and their families and friends are important, with staff providing support to maintain these relationships as much or as little as people want. Contact with family members was recorded within their diaries. The home is large, but the kitchen, although domestic in appearance and equipment is incredibly small in relation. All of the modern domestic appliances such as a microwave, toaster and dishwasher were available and it was clean, tidy and hygienic. One person spoken with said that food is ordered from a local company and delivered on a weekly basis. Anything extra that is needed is then bought locally. People are involved in planning the meals and making their own breakfast and packed lunches, but due to the number of people resident in the home and the size of the kitchen staff always cook the dinner. Generally there are two choices available for people. On the day of the inspection the kitchen was well stocked with a variety of different fresh, frozen and tinned foods. People spoken with said the food provided is nice. Gateway House DS0000004288.V360536.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, 20 Quality in this outcome area is good. The Care plan programmes in place ensure that personal support is consistent, reliable and responsive to peoples needs. The healthcare needs of people are assessed and recognised with evidence of specialist services being readily available to them. Medication policies and procedures ensure that medication is managed safely. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Information regarding the personal support needs of people resident in the home was clearly recorded in a care plan within the files looked at. These were accompanied by a risk assessment if appropriate. People resident in the home have varying personal support needs ranging from minimal prompting to full support. Any support of this nature needed during the inspection was provided sensitively and discreetly behind closed doors. Gateway House DS0000004288.V360536.R01.S.doc Version 5.2 Page 15 Information was available to confirm that people continue to be offered routine healthcare appointments such as the dentist, optician and chiropodist at the recommended intervals. Information was also available to demonstrate that more specialised healthcare needs are addressed as appropriate, such as the attendance at well man and well women appointments, the continence nurse, psychology and psychiatry services and speech and language services. Medication is supplied to the home by Boots in blister packs that are accompanied by medication administration records (MAR). The home stores medication in a locked cabinet in the games / music room. Each person has their photograph attached to their ‘MAR’ chart. Staff on duty said that the house leader is responsible for booking in, reordering and returning medication. All staff receive training in medication administration before they are allowed to undertake this practice. One member of staff talked through the process for administration of medication, and was thorough and competent in her knowledge of the procedure. Examination of the MAR charts for those people chosen for case tracking were completed accurately and did not raise any concerns on the day of the inspection. Gateway House DS0000004288.V360536.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Quality in this outcome area is good. The home has a satisfactory complaints system and can evidence that people’s views are listened to and acted upon. There are policies and procedures in place for the protection of people from harm. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has the organisations policy on complaints in place. There was also an accessible complaints procedure that utilised pictures and symbols available for the people living in the home. These were clearly displayed in the dining room of the home. A complaint log was in place in which to complaints were logged along with the records of the investigations undertaken and the outcome. Neither of these complaints were from people living in the service. People spoken with during the inspection were clear about who they would speak to if they were unhappy about anything. An organisational policy on protection from abuse was available within the home. Training records looked at confirmed that 80 of the staff have received training in the protection of vulnerable adults from abuse. Staff spoken with were able to confirm that they had received training in this area, Gateway House DS0000004288.V360536.R01.S.doc Version 5.2 Page 17 and were able to clearly describe what steps they would take should abuse be suspected, witnessed or disclosed. There have been no allegations of abuse made to us since the last inspection. Gateway House DS0000004288.V360536.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30 The outcome for this group is adequate. The building is large, the layout is complex and not suitable for the people that have some mobility difficulties. Plans are in progress to replace it with more suitable and modern accommodation. The home is clean and hygienic. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is a large detached listed Victorian town house very close to the town centre. There are 11 single bedrooms including the respite bedroom in the main house. There is also a flat on the top floor of the house that can accommodate up to 3 people in single rooms. The communal areas of the house are on the ground floor, and consist of a large comfortable lounge, a quieter music / games room, large dining room and small kitchen. Gateway House DS0000004288.V360536.R01.S.doc Version 5.2 Page 19 The expert by experience who participated in this inspection was shown around the home by one of the people who live there. Comments made by the expert following this tour included “it was very big”, “the layout made me feel uncomfortable”, “one bathroom had a fire escape in it which I didn’t feel was appropriate”, “the flat felt like it was just more rooms attached to the house”, “the dining room was a good size but I was shocked to see the size of the kitchen”. The lounge, games room and dining room were decorated nicely with comfortable, homely furniture and soft furnishings. Peoples bedrooms looked at were also pleasantly decorated to individual tastes with plenty of personalisation. Although the ground floor of the building is laid out in an accessible manner for anyone who may have a mobility difficulty, the remaining floors of the house consist of narrow, confusing hallways, steps and stairs. This coupled with the size of the house means it remains unsuitable accommodation in its present form. The organisation has advised that they wish to move away from large group living and has continued to keep us informed of plans to replace the building with more suitable accommodation. The home has infection control policies and procedures in place, and staff were aware of the personal protective equipment available for their use as necessary. On the day of the inspection the home was clean, tidy and hygienic, with no offensive odours apparent. Gateway House DS0000004288.V360536.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 Quality in this outcome area is good. People benefit from a well-trained, and enthusiastic staff team who work towards common goals. People are supported and protected by the homes recruitment policy. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home employs thirteen staff to support the people that live there, and is staffed on a 24 hour a day basis. Staff rotas looked at confirmed that in general there are a minimum of three staff on duty per shift. Staff spoken with felt that this was appropriate for the number of people living in the home. Staff records were available within the home to confirm that safe recruitment procedures are undertaken to ensure that people are safeguarded. An application form, two written references, a criminal records bureau check (CRB) and terms and conditions of employment were available for all staff. Gateway House DS0000004288.V360536.R01.S.doc Version 5.2 Page 21 The organisation places great store on valuing its staff team by providing consistent training to enable them to do their jobs to the best of their abilities. Staff training records confirmed that 80 of the staff team were up to date with their mandatory training such as first aid, food hygiene and fire safety. Six staff have completed the Learning Disability Qualification induction and foundation programme, two staff have completed their NVQ II and a further two staff have completed their NVQ III. In addition training in subjects such as challenging behaviour, communication, principles of care, epilepsy, infection control, mental health, and the Mental Capacity Act have been provided for staff. Staff spoken with said that the training they received was “very good”, one member of staff who had commenced work recently commented that her induction “is very thorough”. Gateway House DS0000004288.V360536.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 Quality in this outcome area is good. The leadership, guidance and direction provided to staff ensures people receive consistent quality care and support. People are consulted about the quality of life within the home. Health and safety is managed appropriately This judgement has been made using available evidence including a visit to this service. EVIDENCE: A competent, qualified person who was knowledgeable about the home and the people living in it undertakes the management of the service. This person also has management responsibility for the organisations domiciliary care service. In addition there is also a house leader. Gateway House DS0000004288.V360536.R01.S.doc Version 5.2 Page 23 The organisation has a quality assurance system in place that is used is all of the services it operates. This takes the form of annual quality questionnaires that are sent to the people living in the home, relatives and any other key stakeholders. Copies of the most recently completed questionnaires were seen, and the action plan collated from the completed questionnaires received is forwarded to us on an annual basis. In addition, the quality of the service provided was monitored via staff meetings, house meetings and regulation 26 visits undertaken by a representative of the provider. Information was available to demonstrate that the health and safety of people living in the home, staff and visitors is maintained. A sample of health and safety checks was taken, which included portable appliance testing, records of fridge and freezer temperatures and fire alarm points, all of which were up to date. Gateway House DS0000004288.V360536.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 x 2 3 3 x 4 x 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 4 23 3 ENVIRONMENT Standard No Score 24 2 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 4 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 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 3 x 3 x 3 x x 3 x Gateway House DS0000004288.V360536.R01.S.doc Version 5.2 Page 25 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Gateway House DS0000004288.V360536.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection West Midlands West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway Birmingham, B1 2DT 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 Gateway House DS0000004288.V360536.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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