Care Home: Guiding Principles Milligan Ltd

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What the care home does well Residents live in a stable community. They are satisfied with all the services provided by the home as expressed by the Quality Assurance surveys the home has carried out. Their opinions are sought as indicated by staff talking with them and by residents/relatives meetings. They are supported and encouraged to enjoy a positive lifestyle through varied activities, contact with the local community, and contact with family. There are few rules and they have freedom to have their bedrooms the way they like. Staff know about the needs of each resident and this is helped by having very detailed care plans outlining residents needs. Residents are encouraged to live Guiding Principles Milligan Ltd DS0000072640.V375395.R01.S.doc Version 5.2 an independent life. An example being a resident being helped to walk again by staff. Medication systems are of a high standard and medication regularly reviewed to ensure side effects are kept to a minimum. Staff are properly recruited and receive a comprehensive training in order to support the residents living in the home. Guiding Principles is able to support individuals from a diverse cultural background by employing staff who from their cultural background. The home is led by a positive Manager who spends time with residents making sure their quality of life is of a high standard. The health and safety systems are in place to protect residents from harm. What has improved since the last inspection? This is the first inspection of this newly registered service. What the care home could do better: All staff need to read all care plans to ensure they are aware of all residents needs. Activities should be reviewed to look at suggestions made at this inspection to increase them. Meals need to include fruit/vegetables, based on residents choice, to ensure a healthy diet though it is acknowledged that residents are offered fruit twice a day which is a positive practice to encourage healthy eating. All staff need to be aware of the full safeguarding procedure to fully protect residents from abuse. The training programme needs to be extended to include a small number of issues.Guiding Principles Milligan LtdDS0000072640.V375395.R01.S.docVersion 5.2 Key inspection report CARE HOME ADULTS 18-65 Guiding Principles Milligan Ltd 244 Milligan Road Leicester Leicestershire LE2 8FD Lead Inspector Keith Charlton Key Unannounced Inspection 14th May 2009 09:30 Guiding Principles Milligan Ltd DS0000072640.V375395.R01.S.doc Version 5.2 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care home adults 18-65 can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop. The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Guiding Principles Milligan Ltd DS0000072640.V375395.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Guiding Principles Milligan Ltd DS0000072640.V375395.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Guiding Principles Milligan Ltd Address 244 Milligan Road Leicester Leicestershire LE2 8FD 0116 2442004 01162442005 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) Guiding Principles Milligan Hayley Gee Care Home 10 Category(ies) of Learning disability (10) registration, with number of places Guiding Principles Milligan Ltd DS0000072640.V375395.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care Home only - Code PC to service users whose primary care needs on admission to the home are within the following categories: Learning Disabilities - Code LD To service users of the following gender: 2. Either The maximum Number of service users who can be accommodated is: 10 This is a newly registered service. Date of last inspection Brief Description of the Service: Guiding Principles is a small care home providing personal care for people with learning disabilities in the Aylestone area of the City of Leicester. All residents have their own bedrooms, which are personalised and homely. There is a kitchen and dining room and a separate lounge. Residents also have access to the large paved back garden. The fees at the inspection on the 14/5/2009 ranged from £980 to £1380 each week. Information about the home including the statement of purpose and the service user’s guide can be obtained from the Manager. Guiding Principles Milligan Ltd DS0000072640.V375395.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 3 stars. This means the people who use this service experience excellent quality outcomes. ‘We,’ as it appears throughout the Inspection Report, refers to ‘The Care Quality Commission. The inspection process consisted of pre-planning the inspection, which included reviewing the Annual Quality Assurance Assessment (AQAA), which is selfassessment tool completed by the Manager of the service. We have sent surveys to people who use the service along with staff and received five back from staff. All were very positive regarding the care provided by the service and the support given to staff to meet residents needs. The unannounced site visit commenced on the 14th May 2009 and was carried out by Keith Charlton. The focus of the inspection is based upon the outcomes for people who use the service. The method of inspection was ‘case tracking’. This involved identifying people with varying levels of care needs and looking at how these are being met by the staff at Guiding Principles. Two residents were selected, and included people with residential and some nursing care needs. Discussions were held with the Manager and Project Manager, three members of staff, and a District Nurse. We were not able to communicate directly with residents due to their needs and no visitors were present at the inspection. What the service does well: Residents live in a stable community. They are satisfied with all the services provided by the home as expressed by the Quality Assurance surveys the home has carried out. Their opinions are sought as indicated by staff talking with them and by residents/relatives meetings. They are supported and encouraged to enjoy a positive lifestyle through varied activities, contact with the local community, and contact with family. There are few rules and they have freedom to have their bedrooms the way they like. Staff know about the needs of each resident and this is helped by having very detailed care plans outlining residents needs. Residents are encouraged to live Guiding Principles Milligan Ltd DS0000072640.V375395.R01.S.doc Version 5.2 Page 6 an independent life. An example being a resident being helped to walk again by staff. Medication systems are of a high standard and medication regularly reviewed to ensure side effects are kept to a minimum. Staff are properly recruited and receive a comprehensive training in order to support the residents living in the home. Guiding Principles is able to support individuals from a diverse cultural background by employing staff who from their cultural background. The home is led by a positive Manager who spends time with residents making sure their quality of life is of a high standard. The health and safety systems are in place to protect residents from harm. What has improved since the last inspection? What they could do better: All staff need to read all care plans to ensure they are aware of all residents needs. Activities should be reviewed to look at suggestions made at this inspection to increase them. Meals need to include fruit/vegetables, based on residents choice, to ensure a healthy diet though it is acknowledged that residents are offered fruit twice a day which is a positive practice to encourage healthy eating. All staff need to be aware of the full safeguarding procedure to fully protect residents from abuse. The training programme needs to be extended to include a small number of issues. Guiding Principles Milligan Ltd DS0000072640.V375395.R01.S.doc Version 5.2 Page 7 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. Guiding Principles Milligan Ltd DS0000072640.V375395.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 Guiding Principles Milligan Ltd DS0000072640.V375395.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 2. People using the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Guiding Principals have had their needs thoroughly assessed before moving into the home. EVIDENCE: We case tracked a person living in the home who had moved in to Guiding Principals. We checked that information was available to help him/his relatives with the choice of home, though because the person had communication problems it was not possible to check he had received this information. The Manager stated in the AQQA that a thorough assessment is done and that she was looking at providing more accessible information for residents who cannot read. We also checked that the person now living at the home had their needs properly assessed prior to moving to Guiding Principals to ensure that the staff at the home could meet his needs. We found this to be the case as the assessment covered all important issues such as health, behaviour, Guiding Principles Milligan Ltd DS0000072640.V375395.R01.S.doc Version 5.2 Page 10 relationships, medication, sleeping, work and play, personal hygiene, safe environment etc. Guiding Principles Milligan Ltd DS0000072640.V375395.R01.S.doc Version 5.2 Page 11 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9. People using the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The individual needs and choices of each person living at Guiding Principles are well documented and acted upon by staff. EVIDENCE: We looked at the care records of two people living at Guiding Principles. We found very detailed plans to support the care given to people who live at the home. There was a variety of useful information available to staff - Person Centred Plans, Communication passports which detail the best method to give information to a resident, Health Action Plans, Daily Logs, OT and dietician Reports. There are also risk assessments so that residents can be protected from identified risks. Guiding Principles Milligan Ltd DS0000072640.V375395.R01.S.doc Version 5.2 Page 12 Staff said that they read Plans to ensure they can meet residents needs and keeping up to date with Plans is encouraged by management though one staff member said she had not yet read all care plans. We saw that care records were routinely up-dated to ensure they reflected the changing care needs of people living in the homes. During our visit we observed staff and management being very friendly to residents and explaining what they were doing to reassure residents and greeting them when they came back from holiday. There was some evidence that residents are able to live their own lives, e.g. going out to places in the community, choice of meal, choice of activity etc. Guiding Principles Milligan Ltd DS0000072640.V375395.R01.S.doc Version 5.2 Page 13 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): This is what people staying in this care home experience: People using the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Guiding Principles have opportunities to have a varied lifestyle. EVIDENCE: We saw that staff are sensitive to the needs of people living at the homes. They were aware of the preferences of people in their daily activities. We saw staff talk to and interact well with people who live at the home. Staff were aware of how to effectively communicate with each person. There was evidence in plans as to what residents liked to do. One resident liked to visit his family, have meals out, and play the bongos and there was evidence in daily records that he was able to do activities on a daily basis and a photo of him playing the bongos. Guiding Principles Milligan Ltd DS0000072640.V375395.R01.S.doc Version 5.2 Page 14 We looked at the life plans of people who live at Guiding Principals. These contain details of activities recorded so that these can be checked and reviewed as needed to ensure residents needs are met. These showed us that residents are able to experience a varied social life. Some people go to a day centre to take part in snoozelum sessions to provide relaxation and have a variety of activities in the community to choose from. Residents have annual holidays and a number of residents had returned from holiday on the day of the inspection. There were comments in a staff survey that residents ‘need some more arts and crafts and games’, so the Manager is asked to follow this up. We saw tea being served and people living at the home having a meal of sandwiches with a choice of two fillings, sausages and quiche. We indicated that in order to meet the homes stated intention for residents to have a healthy diet that there should be fruit/vegetables included in the tea, which management acknowledged. The Responsible individual pointed out that there is a fresh fruit selection available twice a day to encourage healthy eating. Menus were in place and had sufficient variety. Vegetables need to be recorded to ensure that this variety can be monitored. There was a good awareness amongst staff as to a residents preferred cultural diet. Guiding Principles Milligan Ltd DS0000072640.V375395.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20. People using the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at Guiding Principals receive excellent support in their personal and healthcare needs. EVIDENCE: We looked at the personal and healthcare records of people who live at Guiding Principals. We saw that they have good access to healthcare services to meet their personal and healthcare needs as described in individual Health Action Plans. On talking to staff as well as looking at the records, we found that staff act quickly on concerns they have about peoples needs, and these prompt actions have resulted in a better quality of life for those concerned. We spoke to a District Nurse who praised the staff of the home for their prompt referral to medical services, communication with health services and openness to learning opportunities. Guiding Principles Milligan Ltd DS0000072640.V375395.R01.S.doc Version 5.2 Page 16 The AQAA stated that there are weekly health checks, and three monthly medical reviews and there is access to services – chiropody, physio, District Nurse, optician, dentist etc. We saw that staff properly performed moving and handling practices to ensure residents are safety helped to transfer. We looked at medication management and found that staff are administering medication appropriately to people who live at Guiding Principals, with no instances where medication was not signed as given. Records also showed valuable information regarding allergies and regular medication reviews to ensure residents health is promoted. We also looked at how medication is stored and this was stored safely. We saw staff records and these showed us that staff have undertaken training in the administration of medication. We were informed that only carers are given permission to administer medication to people who live in the home when they have both passed an accredited course and been assessed as being able to issue medication correctly by the management of the home. Guiding Principles Milligan Ltd DS0000072640.V375395.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 22,23. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People, and the families of people who live at Guiding Principles can be confident that their concerns will be noted and acted upon, and they are protected from abuse. EVIDENCE: We looked at the complaints procedure. Management said this is to be displayed in a format which is helpful for people living at Guiding Principles to understand. The procedure does not give the complainant the choice to go directly to the Lead Agency if they wish, instead of the home. The Area Manager said this would be quickly rectified. There is a prepaid envelope to be used to send complaints to Agencies, when needed. We saw good interaction between people who live in the home, and the staff who support them. There is a Complaints folder though no records as there have been no complaints according to management. There is a suggestions book in place which showed that any ideas were recorded and acted upon. Guiding Principles Milligan Ltd DS0000072640.V375395.R01.S.doc Version 5.2 Page 18 We looked at staff training records, and talked to staff and found that staff have a good understanding of safeguarding policies and procedures. Staff know what to do if they suspect that a person who lives in the home is being abused in any way, though one staff member was unsure of all the outside agencies to refer to. Management said they would display a short procedural statement to staff and put safeguarding training in the induction process to tighten this area of practice. People who live in the home have their own bank accounts. Staff support people living at Guiding Principles in dealing with their money. We checked the financial records of two people living at the home, and found good recording of money transactions. Guiding Principles Milligan Ltd DS0000072640.V375395.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 24,30. People using the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a clean, comfortable and homely environment, which meets their needs well. EVIDENCE: We looked at the communal areas of the homes and some of the bedrooms of people who live there. We found the communal areas to be satisfactorily decorated and homely. The bedrooms were decorated to reflect the personalities and preferences of the people using them. There were suitable aids and adaptations around the home to assist residents in their daily care. Guiding Principles Milligan Ltd DS0000072640.V375395.R01.S.doc Version 5.2 Page 20 The AQAA told us that residents choose how they like their bedrooms to be by choosing the decor etc. We found this to be the case in a bedroom that had a dolphin themed décor and another bedroom with a football theme. The Manager talked about how maintenance is quickly followed up as she can contact suitable people quickly to rectify any issue. We saw that the home was well maintained. The home was clean and tidy, apart from a slight odour in the lounge. Management explained that there is regular intensive cleaning and this could be attended to. The garden to the rear is paved and looked in a kept condition, with garden furniture there so that residents could use it in good weather according to the staff use. The Manager said there were plans to install a snoozelum the near future, as residents liked this facility when they used it in the community, and that the home were trying to obtain an allotment for the home. We looked at a bedroom of a resident having bed rest and the Manager confirmed he would soon be having a new TV which will be positioned better for him to see it. There were locks to bedroom doors originally installed to prevent people invading privacy etc though there is also a potential they could be used to keep people in their bedrooms. Management said they would be swiftly taken out and this was confirmed to have been done within seventy two hours. Guiding Principles Milligan Ltd DS0000072640.V375395.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35. People using the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in the home have good staffing levels and support from a motivated and well trained staff team. EVIDENCE: The staff rota indicated that when all residents were in the home, there were a minimum of five care staff on duty with two awake staff members at night. Staff and management confirmed that although residents have high dependency needs there are enough staff to ensure that residents receive individual attention frequently and we saw evidence of this during the inspection. We talked to staff and saw them supporting people who live in the home. We saw good interaction between staff and people who live in the home, and staff demonstrated a very good understanding of the needs of people living there. Guiding Principles Milligan Ltd DS0000072640.V375395.R01.S.doc Version 5.2 Page 22 Staff said they were supported well to do their job by management, and there is detailed induction training and on going training relating to the job they do, with regular supervision, which we found to be the case. We looked at a sample of staff records, and saw that all the necessary checks were made to safeguard people who live at the home. We looked at training records and this confirmed that staff have undertaken relevant training to help them in their roles. Training included a large range of issues - health and safety, medication management, infection control, fire, food, hygiene, moving and handling though no learning disability or challenging behaviour training - the Manager said that she would include this in the home’s training programme. The Manager confirmed that all staff have undertaken NVQ training and five staff are attending specialist training on learning disability issues to raise awareness of all relevant issues in residents care. Guiding Principles Milligan Ltd DS0000072640.V375395.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42. People using the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Health and safety systems are in place to protect residents welfare. EVIDENCE: The Registered Manager, Hayley Gee, has NVQ4 and Registered Manager Award Qualifications, which we saw evidence of. Hayley was praised by staff for her efficient and effective, supportive leadership. We saw evidence of her spending time with residents - talking to residents in a friendly fashion asking them how they enjoyed their holiday etc. Hayley said she was doing specialist learning disability training at present. Guiding Principles Milligan Ltd DS0000072640.V375395.R01.S.doc Version 5.2 Page 24 There are quality assurance and monitoring systems in place, and we saw the questionnaires that go out to all relevant parties to ascertain peoples views of the service so that improvements can be made if needed. The Line Manager said this system was to be further developed so ensure that results and improvements are clear to all. There were very positive comments in the questionnaires: ‘Very professional and polite’. ‘Caring environment and very person centred’. Staff ‘are always excellent and very caring’. A GP stated: ‘An outstanding home and I see many’. There are good systems in place to support staff - staff supervision is regular and detailed, staff meetings are frequent and include how to improve practice and there is an employee of the month award to help staff to strive toward the best quality practice to make sure residents quality of life is as good as it can be. We checked some residents monies records, which were found to be detailed and in order with a weekly checking system in place. The AQAA informed us of the policies and procedures the service works to, to ensure good health and safety practice in the home. The temperatures of water is regularly checked to ensure residents are protected from scalding water. We tested the water and found it was within the safe standard. Risk assessments are in place for safe working practices and fire risks were seen to be covered by regular testing and a fire risk assessment being in place. The Manager was asked to look at increasing the frequency of fire drills so that staff always remember the proper fire procedure. The staff we spoke to were aware of how to properly follow the fire evacuation procedure. The Environmental Health Report of 12/3/09 regarding food hygiene showed that the home’s practices were very good. We spoke about reviewing the risk assessment for window restrictors to fully protect security. The Manager said this would be done and rang us to confirm that it had been. Guiding Principles Milligan Ltd DS0000072640.V375395.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 4 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 4 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 4 33 X 34 4 35 4 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 X 4 X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 X 15 4 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 4 X 4 X 4 X X 4 X Version 5.2 Page 26 Guiding Principles Milligan Ltd DS0000072640.V375395.R01.S.doc Are there any outstanding requirements from the last inspection? No 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 Guiding Principles Milligan Ltd DS0000072640.V375395.R01.S.doc Version 5.2 Page 27 Care Quality Commission East Midlands Region Citygate Gallowgate Newcastle upon Tyne NE1 4PA National Enquiry Line: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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