Care Home: Hartington House

What the care home does well Whilst there have been some changes in the team, remaining members have worked at the home for sometime and have a good understanding about meeting peoples needs. People at the home appeared very settled and made the inspector very welcome. Both staff and people at the home continue to be supported by the relevant mental health teams. The home has built up good working relationships with them, which assists them in helping to maintain their health and well being. The inspector spent time speaking with each person. All appeared happy and relaxed to talk. We also received comments in the feedback surveys. People confirmed that they had been asked if they wanted to move in, that they were able to do what they want to do, that they know who to speak to if not happy and that staff treated them well. One person said, `I want to keep this home`. Staff feedback was also received. They said; `the service meets the needs of every service user` and `all the service users needs are well met`. Staff confirmed that they received training and support, that information was shared within the team and that there was usually enough staff on duty. What has improved since the last inspection? Improvements have been made to the environment, both inside and outside of the home providing comfortable surroundings for people. The staff continue to receive on-going training and development ensuring the have the right knowledge and skills needed to support people properly. Whilst there have been some changes in the staff team the manager and senior staff have worked at the home for sometime therefore offering some stability. Each are clear about their roles ensuring people are supported in a way in which they choose. The office environment was better organised. Old information had been removed for archiving providing a better working space with up to date information for staff. What the care home could do better: Risk assessment must be completed in are areas where there is potential risk ensuring staff know what support is required and people are protected. Records completed for controlled drugs need to accurate and signed by two members of staff ensuring the practice followed is safe. Where incidents have occurred in relation to the well-being of people at the home these should be reported to us in line with Regulation 37 along with all action taken. An up to date check should be arranged with regards to small appliances ensuring items used are safe. Items stored within the electric cupboard must be removed so that this does not create a hazard and potentially place people at risk. The manager should explore mental health training for the new inexperienced staff so that they have an opportunity to develop their knowledge regarding the specific needs of people they support. When auditing the staff files the manager must ensure that all relevant checks are in place along with relevant dates so that information clearly evidence that there are safe and robust recruitment procedures in place. The manager is asked to provide an up to date staff training matrix showing what training has been completed by staff along with future courses ensuring their continued professional development. CARE HOME ADULTS 18-65 Hartington House 14 Hartington Road Heaton Bolton Lancashire BL1 4DP Lead Inspector Lucy Burgess Unannounced Inspection 15th September 2008 09:30 Hartington House DS0000009315.V371485.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 Hartington House DS0000009315.V371485.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. Hartington House DS0000009315.V371485.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hartington House Address 14 Hartington Road Heaton Bolton Lancashire BL1 4DP 01204 410854 01204 493126 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) Perpetual (Bolton) Ltd Mrs Tricia Varey Care Home 5 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (5) of places Hartington House DS0000009315.V371485.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 - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Mental disorder, excluding learning disability or dementia - Code MD The maximum number of service users who can be accommodated is: 5 Date of last inspection 26th September 2007 Brief Description of the Service: Hartington House is a small care home providing residential care for up to 5 people with mental health needs. The basic fee charged is £750.00 however this may vary depending on assessed needs. The home is part of a small group of two homes (the other being Somerset House). Both homes share the same staff team and are situated near to each other in the residential area of Heaton in Bolton. There is a small office at Hartington House, although the main office base for the two homes is at Somerset House. A local company, Perpetual Care, owns the home, with the day-to-day management carried out by the Registered Manger. Hartington House is an end terrace house, consisting of 5 single bedrooms and communal areas. The house is close to a main road leading into Bolton town centre and is accessible to local amenities and public transport. Residents are generally of a younger age range at Hartington House than those at Somerset House. Hartington House DS0000009315.V371485.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 stars. This means the people who use this service experience good quality outcomes. This was an unannounced visit to the home. The inspection was carried out over one day, between the hours of 9.30am to 3.30pm. During the visit time was spent looking at paperwork and the environment. Time was also spent speaking with people at the home, the staff and the manager. Before the inspection, we also asked the manager of the home to complete a form called an Annual Quality Assurance Assessment (AQAA) to tell us what they felt they did well, and what they needed to do better. This had been completed and returned to us before our visit to the home. Feedback surveys were also sent to people at the home and staff. The inspector received 4 completed surveys. Comments have been added to the report. The home is registered to provide accommodation for 5 people. There were no vacancies. What the service does well: Whilst there have been some changes in the team, remaining members have worked at the home for sometime and have a good understanding about meeting peoples needs. People at the home appeared very settled and made the inspector very welcome. Both staff and people at the home continue to be supported by the relevant mental health teams. The home has built up good working relationships with them, which assists them in helping to maintain their health and well being. The inspector spent time speaking with each person. All appeared happy and relaxed to talk. We also received comments in the feedback surveys. People confirmed that they had been asked if they wanted to move in, that they were able to do what they want to do, that they know who to speak to if not happy and that staff treated them well. One person said, ‘I want to keep this home’. Staff feedback was also received. They said; ‘the service meets the needs of every service user’ and ‘all the service users needs are well met’. Staff confirmed that they received training and support, that information was shared within the team and that there was usually enough staff on duty. Hartington House DS0000009315.V371485.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Risk assessment must be completed in are areas where there is potential risk ensuring staff know what support is required and people are protected. Records completed for controlled drugs need to accurate and signed by two members of staff ensuring the practice followed is safe. Where incidents have occurred in relation to the well-being of people at the home these should be reported to us in line with Regulation 37 along with all action taken. An up to date check should be arranged with regards to small appliances ensuring items used are safe. Items stored within the electric cupboard must be removed so that this does not create a hazard and potentially place people at risk. The manager should explore mental health training for the new inexperienced staff so that they have an opportunity to develop their knowledge regarding the specific needs of people they support. When auditing the staff files the manager must ensure that all relevant checks are in place along with relevant dates so that information clearly evidence that there are safe and robust recruitment procedures in place. The manager is asked to provide an up to date staff training matrix showing what training has been completed by staff along with future courses ensuring their continued professional development. Hartington House DS0000009315.V371485.R01.S.doc Version 5.2 Page 7 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. Hartington House DS0000009315.V371485.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 Hartington House DS0000009315.V371485.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Needs are assessed before anyone is admitted to the home ensuring the placement is suitable and peoples needs can be met. EVIDENCE: Since our last visit a new person has moved into the home. They were admitted directly from hospital as part of the discharge plan. This person is subject to a care programme plan (CPA), which involves their health being monitored by mental health and social care professional. In considering the suitability of the placement a lot of information had been received by the home detailing the persons health and social care needs, a history of their mental health and social background, details in relation to risk and medication. This information was extremely detailed with regards to what assessments and interventions have been made by mental health professionals and the level of support required. Staff spoken with were very aware of the persons needs. Issues had arisen following admission however had now settled down. This person was seen during the visit and briefly spoken with. They appeared relaxed and settled and interacted well with staff. Hartington House DS0000009315.V371485.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Good care plans and care practices ensure that people’s needs are met in a safe and dignified way. EVIDENCE: The care plan and risk assessments were looked for the newest person. As already identified, detailed assessment information had been provided prior to their admission. This information had been used to develop the care plan and risk assessments. Those records seen had been reviewed and updated providing clear information about the persons support needs. The plan detailed the person physical and mental health, accommodation needs, personal support, family contact, finances, religious/cultural needs, communication, and relevant treatment. Hartington House DS0000009315.V371485.R01.S.doc Version 5.2 Page 11 Information showed that this person had specific support needs due to number of areas of potential risk, which had been identified in their assessment and care plan. Risk assessments had been completed in relation to absconding, physical health and smoking, however further assessments were required with regards to additional medication to be given ‘when required’ (PRN) as well as issues in relation to their mental health and behaviours. Due to the level of vulnerability of this person, their past history and the potential harm they may place themselves in clear assessments need to the put in place. These should clearly explain to staff what they need to do to minimise such risk as well as the action to take should a concern arise. This will ensure people are protected from harm. The manager stated that these would be put in place immediately following our visit. Other documentation is maintained including the daily evaluation sheets. These detail the person daily routine, personal care, meals, appointments, and medication. Additional records regarding weights, health appointments and medication are also held ensuring peoples health and well-being is maintained. We also received comments in the feedback surveys. People confirmed that they had been asked if they wanted to move in, that they were able to do what they want to do, that they know who to speak to if not happy and that staff treated them well. One person said, ‘I want to keep this home’. Hartington House DS0000009315.V371485.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, 14, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Some opportunities are provided for people to allow for activities of their choosing however staffing levels could be more flexible so that people routines can be accommodated. EVIDENCE: At present no one undertakes any formal employment or college courses, preferring a more relaxed routine. Each person follows their own routine, which are in the main independent of each other. This may involve shopping, library, visiting the local community centre and drop-in as well as watching television or listening to music. People at the home also have access to a vehicle, which is used when attending appointments or outings. This is also used when people are going on family visits. They are asked to contribute to the petrol costs. People also have access to travel pass so that they can travel independently using public transport should they wish too. Hartington House DS0000009315.V371485.R01.S.doc Version 5.2 Page 13 Occasionally group outings are arranged. One was being planned for the week following the visit to Blackpool to see the Illuminations and have fish and chip supper. One person spoken with said that they had organised a Christmas party last year, which included a quiz and karaoke. This had been a great success and was being planned again for this year. It appeared at times that opportunities to develop peoples own interests are limited due to the staffing ratio. Whilst some people are able to go out independently others require one-two one or two staff to support them whilst in the community. As each of the people living at the home have varying skills and abilities this can at times be restrictive if staff are needed to support people on appointments etc. People continue to have contact with family and friends either by telephone or visits to each other homes. Contact is made on a regular basis. Where necessary specific agreements have been made with regards to home visits, these are monitored and reviewed. Visit take place at the home by someone from the local mental health advocacy group, MHIST. Occasional meetings are held and provide people with further opportunity to discuss any issues they have as well as receiving additional support. People also attend the monthly craft group held at the advocacy group offices. Meal times continue to be relaxed. This is dependant on individual preferences and routines. Those wishing to cook can with the support of staff if needed. One person is able to manage independently. People are generally encouraged to prepare there own breakfast and lunch with the evening meal being prepared by staff. Food items are stored within the basement and included fresh, frozen, dried and canned goods. The weekly shopping trip had been planned for later in the day. Arrangements are also made with regards to halal foods as one person follows a halal/vegetarian diet. The kitchen was clean and tidy and a new dining table and chairs had been provided. People are encouraged to follow a healthy diet and staff continue to monitor meals and weight. Hartington House DS0000009315.V371485.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are consistently offered the health and personal care support they prefer and need ensuring their health and well-being is maintained. Medication is generally well managed however minor improvements are required to ensure practice is safe. EVIDENCE: Each of the people living at the home is supported by a mental health professional as part of their individual care programme plan (CPA). These vary depending on agreements made on discharge from hospital. As part of the CPA formal reviews are held on a 6monthly basis to monitor the health of people as well as review their medication. Additional support and advice is available to the staff should this be needed. People also have access to other health care professionals including a local GP, community psychiatric nurses, dentist, and optician. Appointments are made with local clinics for blood test or well being checks. Hartington House DS0000009315.V371485.R01.S.doc Version 5.2 Page 15 We were advised that one person continues to refuse any input from health care professionals and has been refusing to attend visits to the surgery or when made at the home. Staff have made this known to their social worker and psychiatrist and continue to monitor this. The medication system was examined. Staff are appropriately trained before they take on the responsibility of administrating medication to people. At present a controlled drug is being administered for one person. This is stored securely however information within the controlled drug book was incomplete. On 2 occasions the time of administration had not been stated and only one member of staff had signed the record. As there are 2 staff on duty throughout the day and night, records should be signed and witnessed by both staff to ensure that practice is safe. Individual administration records (MAR) are in place. Items had been counted, checked and signed for on receipt and then signed by staff following administration. Items were stored safely. Two items had been left on top of the staff desk. Neither of these were items recorded on the current MAR sheets and one item did not have a prescription label identifying who it belonged too. These should be returned to the supplying pharmacist. Hartington House DS0000009315.V371485.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Suitable arrangements are in place with regards to complaints and protection ensuring people are listened too and their safety maintained. EVIDENCE: The service has a complaints procedure which people are aware of. Since the last inspection there have been no issues or concerns raised at the home as identified on the AQAA or directly with us. The home has a copy of the local authority safeguarding procedure. Staff have received the relevant training through the local partnership training group and are aware of their responsibilities should an issue arise. The manager is also aware of her role and has actively sought advice from members of the safeguarding team when necessary. Suitable arrangements are in place with regards to the management of people’s money. Individual records are maintained with all transactions recorded as well as receipts held. One person manages their own affairs without the support of staff. A random sample was checked, no errors were found. We were advised during the visit that there had been 2 separate issues, which had arisen with regards to people’s finances. These were in relation to a theft from individual bank accounts and did not involve the home. Appropriate Hartington House DS0000009315.V371485.R01.S.doc Version 5.2 Page 17 steps had been taken by the manager and staff to ensure that the matters were reported and all necessary action taken. Hartington House DS0000009315.V371485.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 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Some improvements have been made to the property so that people live in a comfortable environment. EVIDENCE: We looked at what progress had been made to those areas identified during our last visit. Action had been taken in relation to the fascias being replaced, a new roof and part of the walls had been re-pointed. Action has also been taken with regards to a replacement closing devise being repaired in one of the bedroom. It was noted however that items were still being stored in the electric meter cupboard. These must be removed. One of the bedrooms has also been completely redecorated and refurbished following another person leaving the home. This involved new flooring, a new radiator, new furniture and curtains as well as being repainted. Hartington House DS0000009315.V371485.R01.S.doc Version 5.2 Page 19 New furniture has been purchased for communal areas including a new suite and coffee table in the smoke lounge, 2 bed settees for staff in the second lounge. There was also a new dining table and chairs in the kitchen and outside furniture in the rear yard. The front garden was tidy and nicely presented. There is also an enclosed yard to the rear offering some privacy. Old items of furniture were being stored. We were advised that arrangements had been made to remove these. The staff continue to carry out most of the domestic tasks however people are encouraged to assist. Hand washing facilities are in place in both the kitchen and laundry area to ensure the prevention of cross infection. The home was found to be clean and tidy during the visit. Hartington House DS0000009315.V371485.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, 33, 34, 35 and 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Systems are in place with regards to the recruiting, training and supervisions of staff ensuring they have the knowledge and skills needed to meet people’s needs. EVIDENCE: Staffing arrangements remain the same with the staff team working at both Hartington House and the sister home, Somerset House. Two staff are on duty throughout the day and night, with two sleep-in staff at night. Since our last visit 5 staff have left the service. However recruitment has taken place with 2 new staff having joined the team and a third person due to commence their employment. Recruitment information and checks were looked at for the two staff that have already commenced work. Files were orderly and included an application with full employment history, health declaration, copies of identification, POVA 1st check, training certificates and supervision notes. Hartington House DS0000009315.V371485.R01.S.doc Version 5.2 Page 21 We found that written references and evidence of criminal record checks were not available. The manager explained that plans had been made to audit staff files with a member of staff from head office to ensure that all relevant documentation was available at the home. The manager must ensure that the necessary information is available prior to people commencing their employment ensuring they are suitable for the post and people are not placed at risk. Training was also looked at. The service is a member of the local training partnership group. Staff have received training updates in medication level 2, health and safety, food hygiene, moving and handling and first aid. The manager must ensure that she can evidence that all staff have received the necessary training and that they are supported in their continued professional development. National vocational qualifications (NVQ) training are also provided. Of the current 9 support staff, 6 have already completed level 2 of which 6 have gone on to complete or have achieved level 3. The manager has also completed her NVQ level 4/Registered Managers Award and the assessors award. We have already received copies of her certificates. New staff undertake the local authority 7 day induction programme, which includes all essential training. There is also an in-house induction, which informs staff of the homes policies and procedures. Staff confirmed that they had also received a copy of the staff handbook. It was noted the 2 new staff and the 3rd member yet to start have no previous experience of care work or of working with people with mental health needs. The manger was asked to explore some training in this area to enable them to develop their knowledge and understanding. The manager explained that this could be provider a local training service. Supervisions sessions are also being carried out. The senior staff do these with support staff and discussions are recorded. Copies were seen on those staff files examined. Staff feedback was also received. They said; ‘the service meets the needs of every service user’ and ‘all the service users needs are well met’. Staff confirmed that they received training and support, that information was shared within the team and that there was usually enough staff on duty. Hartington House DS0000009315.V371485.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 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The overall management and conduct of the home remains consistent and reliable ensuring it is run in the best interests of people living at the home. EVIDENCE: The manager continues to support both Hartington House and the sister home Somerset House. She is supported in her role by two senior support staff that take on additional day-to-day responsibilities. Whilst the team has gone through a period of change a number of staff have worked at the home for a number of years and therefore have worked closely together. The manager is clear about her responsibilities and demonstrates a good understanding of the needs of people. The manager keeps herself up to date Hartington House DS0000009315.V371485.R01.S.doc Version 5.2 Page 23 and informed of current legislation and guidance as well as undertaking periodic training. Systems are in place with regards to quality monitoring. These include; regular staff training, supervision and support. Reviews are carried out ensuring the home is still able to meet the needs of people as well as maintaining good links with mental health and social care professionals. Feedback from people living at the home is done on a more informal basis, as some people do not like the formality of a meeting. Further checks are also carried out within the environment to ensure people are safe. It is advised that this information is used to develop the home annual development plan. Copies of such this should be shared with people involved with or who have an interest in the home. In relation to health and safety weekly checks continue to be carried out by staff. This includes checks to both the inside and outside of the building, fire safety and water temperatures. A recent fire drill had been undertaken involving staff and all those living at the home. External professionals had serviced other areas within the home. A sample of servicing certificates was seen. These included; gas safety, 5year electric check, fire alarm and emergency equipment. Testing for the small appliances was due. The manager who has been appropriately trained carries this out. As already identified several incidents have occurred in relation to people living at the home. These had not been reported to us in line with regulation 37. The manager should ensure that this information is forwarded to us at the time the incident occurred and then followed up with action taken to address any issues arising. Hartington House DS0000009315.V371485.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 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 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 2 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 2 X LIFESTYLES Standard No Score 11 3 12 2 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 3 X X 2 X Hartington House DS0000009315.V371485.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA9 Regulation 13(4) Requirement Where areas of potential risk have been identified a detailed risk assessment must be undertaken identifying action to be taken to minimise such risk ensuring the safety of residents and staff. Items stored within the electric cupboard must be removed so that this does not create a hazard and potentially place people at risk. The manager must ensure that all relevant checks are in place along with relevant dates so that information clearly evidence that there are safe and robust recruitment procedures in place. Any incidents affecting the wellbeing of residents must be reported to the CSCI and followed up with any action taken to ensure the safety of residents. (Previous timescale not met 30.11.07) Timescale for action 30/11/08 2 YA24 13(4) 30/11/08 3 YA34 19 Schedule 2 30/11/08 4 YA42 37 30/11/08 Hartington House DS0000009315.V371485.R01.S.doc Version 5.2 Page 26 5 YA42 23 Arrangements must be made for the small appliances to be tested ensuring they are safe to use. 30/11/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA12 Good Practice Recommendations Consideration should be given to the staffing rotas so that staff are available at such times to support/facilitate activities chosen by those living at the home enabling them to live a lifestyle of their choosing. Accurate records must be maintained with regards to controlled drugs ensuring practice is safe and people are not placed at risk. The manager must evidence that staff receive on-going training ensuring their continued professional development. The manager should explore suitable training for new inexperienced staff ensuring they have the knowledge and skills need to support people living at the home. That a quality assurance report in is written outlining the development plans for the home and made available to those people involved or has an interest in the home. 2 YA20 3 YA35 4 YA35 5 YA39 Hartington House DS0000009315.V371485.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Manchester Local office 11th Floor West Point 501 Chester Road Manchester M16 9HU 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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