Care Home: Homefield House

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What the care home does well What has improved since the last inspection? The acting manager Mr Umerah is now registered with the Commission. Requirements made at the previous inspection in September 2007 have been addressed and so have most of the recommendations. Door locks have been fitted and old furniture replaced. We are advised that the owners, LondonBorough Croydon [LBC] have now agreed that permanent staff can be recruited and this is underway. What the care home could do better: CARE HOMES FOR OLDER PEOPLE Homefield House 57 Homefield Road Old Coulsdon Surrey CR5 1ET Lead Inspector Michael Williams Unannounced Inspection 10:00 16th June 2008 X10015.doc Version 1.40 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 Homefield House DS0000043327.V364276.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 Older People. 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. Homefield House DS0000043327.V364276.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Homefield House Address 57 Homefield Road Old Coulsdon Surrey CR5 1ET 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) 01737 551880 01737 551681 patrick.umerah@croydon.gov.uk London Borough of Croydon Mr Patrick Onweazuka Umerah Care Home 35 Category(ies) of Old age, not falling within any other category registration, with number (35) of places Homefield House DS0000043327.V364276.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 with nursing - Code N to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP (of the following age range: 65 years and over) The maximum number of service users who can be accommodated is: 35 18th September 2007 2. Date of last inspection Brief Description of the Service: Homefield House is owned and managed by the London Borough of Croydon. A number of large bedrooms have been converted into single rooms or lounge space so the home now has thirty-five places. The Local Authority is also changing the homes stated purpose; currently in transition it now offers intermediate care and social ‘re-ablement’ care, that is rehabilitation, for residents and the home also continues to provide respite care. The home is an older style, purpose built detached property situated in a quiet residential area of Old Coulsdon. There are currently separate lounge and dinning areas on each floor of the home and it has a well-equipped kitchen on the ground floor. Sufficient numbers of bathroom and toilet facilities are conveniently located throughout the home. Laundry and sluicing facilities are also available on each floor. The home has a large garden and there is limited space for parking. Fees in 2007/2008 were £467. Extra is charged only for personal requisites and items residents wish to buy. Homefield House DS0000043327.V364276.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 visit was conducted in early summer 2008 and included the distribution of questionnaires to relevant parties including people who use the service (in this home referred to as residents), their relatives, care managers, health care professionals and all grades of staff in the home. From this the Commission received at total of eight replies. All were very positive about the Home and the quality of care provided by the staff. The site visit was from late morning until tea-time and many residents had an opportunity to talk to the inspector; several relatives were visiting on this day and they were most helpful in commenting on the manner in which Homefield House is conducted. Comments were also received from a visiting Community Nurse. Several members of the staff team, including the cook, were also interviewed. A range of documenttation including statutory records were checked. Not all the staff in Homefield House are now employed by the London Borough of Croydon; catering and housekeeping is now managed by a private company. The Home’s manager therefore loses direct day to day management of kitchen and cleaning staff. The Commission will need confirmation that National Minimum Standards can be met and Statutory Requirements complied with. What the service does well: What has improved since the last inspection? The acting manager Mr Umerah is now registered with the Commission. Requirements made at the previous inspection in September 2007 have been addressed and so have most of the recommendations. Door locks have been fitted and old furniture replaced. We are advised that the owners, London Homefield House DS0000043327.V364276.R01.S.doc Version 5.2 Page 6 Borough Croydon [LBC] have now agreed that permanent staff can be recruited and this is underway. 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. Homefield House DS0000043327.V364276.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Homefield House DS0000043327.V364276.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): NMS 3: People using this service experience good quality outcome in this area. We have made this judgement using a range of evidence, including a visit to this service. Social care and health care needs are assessed prior to admission, this ensures that residents will know that staff in the home will be able to meet their changing needs. The home also has in place arrangements to provide rehabilitation support and these residents can also be assured that their needs will be assessed prior to admission to ensure their placement in this particular home is appropriate. EVIDENCE: A sample of case notes was checked. As well as talking to many of the residents we also spoke to the person in charge and some of the staff team. A few relatives were also interviewed during the course of this and the previous inspections; the residents told us about their experiences at the time of their admission to the home, which is often a transfer from hospital rather than from their own home. In some cases residents are staying for only a short Homefield House DS0000043327.V364276.R01.S.doc Version 5.2 Page 9 period of time – for respite care, perhaps whilst family supporters are away on holiday. The pre-admission assessments include general information about each resident, details of their background medical and social history and comprehensive details of specific issues such as mobility nutrition, diabetes, continence, medication and diversity needs or choices. Residents, with their representatives, assist in the compilation of these case notes. We noted that on the day of admission a member of staff was allocated to meet the resident when they arrived and to help introduce them to the home and other residents. We also saw that the senior member of staff met with the new residents to take note of key issues such as medication, money and special needs. The home’s management team has taken the initiative and arranged meetings with senior care managers to discuss the issue of pre-admission information and referrals. These meetings are very important to ensure the home’s role and limitations are clearly known to all relevant agencies and inappropriate placements can be avoided and the person in charge is now confident that only appropriate referrals are being made since some clarity was brought to the admission criteria. In particular the home does not admit residents with nursing care needs that cannot be met by a visiting District Nurse. Areas of strength include the preparation for admission and information provided and as no matters requiring improvement arise this section, about choice on admission, is assessed as good. Homefield House DS0000043327.V364276.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): NMS 7 to 10: People using this service experience good quality outcome in this area. We have made this judgement using a range of evidence, including a visit to this service. Care Plans are in place for each resident. This means that, so long as the placements are appropriate, the needs of residents can be met. Medication can either be administered by the care staff or they will support residents to hold and administer their own medication in order to maximise their independence. Residents are treated with respect and dignity. EVIDENCE: A sample of residents case files were read; residents and relatives were interviewed; staff and visiting professionals, a Community (District) Nurse her opinion and the person in charge also explained how they aim to met the social and health care needs of all residents. The administration in this home is very good and the case files were in good order despite the range of services on offer – some residents are long stay others admitted for respite and others for rehabilitation support before returning home - so the case files need to be well managed and they are. My first examination of file did not include up to date care plans but I later learned that these are kept in a separate folder for daily use and whilst this was at first confusing it is nonetheless commendable since Homefield House DS0000043327.V364276.R01.S.doc Version 5.2 Page 11 it means staff, and residents, have access to the latest and most relevant documents in smaller, more manageable folder. Pre-admission information is in place and this helps direct the in-house assessments and care planning. A range of documents are required to be maintained for each resident including items such a photograph, basic personal data, health and social care needs, professional and family involvement and so forth. Care plans and reviews are in place for each residents and the daily notes indicate that staff are providing suitable care and support for each resident. During the inspection it was noted that the home’s staff make prompt and direct contact with health care professionals such as a Nurse or Doctor if the need arises as it did on the day of inspection. The visiting Nurse and Physiotherapist and an ambulance driver all attested to the professional manner in which this home is being run. No errors were identified in the procedures for recording, storing, administering and returning medication. In most instances staff assist residents with their medication but for those residents intending to return home the care staff can support residents in looking after their own medication in their rooms. Areas of strength include the well managed documentation to support care practices and the residents’ views that they are well cared for and as there are no matters requiring improvement in this section, about health and social care, it is assessed as good. Homefield House DS0000043327.V364276.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): NMS 12 to 15: People using this service experience good quality outcome in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a comfortable setting for residents to engage in social and cultural activities as they choose and in accordance with their expectations for the home including any ‘diversity’ issues. The staff assist and encourage residents to lead as fulfilled lives as they wish or their frailty allows. Residents are encouraged and given every opportunity to maintain contact with family and friends and the community. A full and wholesome diet is available for all residents. EVIDENCE: The most important aspect of this section is that in 2007 the residents said they were very happy in Homefield House, they want to stay and they don’t want any changes made. It was therefore very commendable that once again residents, and staff, told us what a happy home this is; as demonstrated by the laugher we heard from the ground floor lounges whilst we were touring the home. This reflects the pleasant, tranquil atmosphere evident during this visit. A visiting care manager also commented on the good first impression one gets when arriving at Homefield House. There is ample space for residents to sit where and with whom they please. Staff were with residents throughout the Homefield House DS0000043327.V364276.R01.S.doc Version 5.2 Page 13 day and often engaging them in some activity such as gentle exercise or conversation. It was also pleasing to hear residents in the ground-floor lounge supporting each other and chatting about their news and views – clearly a group of residents who are getting on well together – on the day there was shared anxiety about a resident who was a little poorly over the weekend; we were told she had gone to hospital for a ‘check-up’, which reassures residents they will be properly attended to if they fall ill. It is expected that a care home will support residents to maintain links with their family, friends and the wider community and this is the case here. Visitors are welcomed, residents still go out to visit their family and friends when they wish and representatives from the community come in regularly including church members and entertainers. Several visitors were on site to confirm that they may visit freely and are welcomed by staff. One resident, over 80 years of age, was pleased to show me her mobile phone that she uses to keep in touch with her family. The manager advised the inspector that all residents use English as their language of choice although one or two are not English by birth. Most staff are not indigenous English and their language skills vary but the wide range of backgrounds of the staff team does mean residents have some choice in this matter. Male staff are employed to offer choice about who will provide intimate care and support. Other aspects of diversity were discussed such as the accommodation of residents who may have sensory or mobility problems – the home seeks to meet such needs whenever possible. Matters of sexual diversity were also discussed in previous visits. Given the age of the client group many reflect on how different things were when they were young. In it is clear that in Homefield resident, and the staff themselves, will be treated with tolerance and forbearance whatever their lifestyle or sexual orientation. This service offers rehabilitation but there seemed little evidence of this during our visit; this may be due to the frailty of resident – even those hoping to return home were not very active. Many routines seem geared to permanent care rather than preparation for independent living. For example all meals are served from the main kitchen with little evidence that the excellent facilities on the first floor are being used to optimise independent living. We also note that Occupational Therapy seemed not to be readily available even though specialist support of this sort would help both residents and the carers to maximise the facilities available on the first floor. We discussed in some detail the rights, and responsibilities, of the more independent residents and how to manage challenging issues that arise. One matter suggested for further training is staff knowledge about the Mental Capacity Act and how it will influence decisions about residents’ care and support. A recommendation is made about this area. Areas of strength are the residents’ universal opinion that this is an ideal setting in which to be cared for and as no matters requiring improvement arise in this section, about daily life, it is assessed as good. Homefield House DS0000043327.V364276.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): NMS 16 and 18: People using this service experience good quality outcome in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents can be assured they will be listened to and will be safeguarded from abuse. EVIDENCE: Questionnaires were sent out to residents, cares and families, professional visitors as well as staff in the home. Their comments are outlined in the summary to the report and indicate that residents are confident that their voice is listened to and their concerns noted and acted upon. Records were checked and residents interviewed. Residents and their visitors confirmed that suitable arrangements are in place to complain or make representations, they are confident their opinions and concerns are dealt with in a professional and thoughtful manner. A record of complaints is in place but this was difficult to follow. No complaints arose during the course of the inspection. In contrast several complimentary comments were made by those people interviewed. Two complaints were received by the Commission in 2008 and these were passed on to the owners, the London Borough of Croydon, to investigate using their own procedures which included an independent element to the investigation. We are advised the complaints were not substantiated. The home has an up to date copy of the local authority’s procedures for dealing with allegations of abuse but no such issues have arisen since the previous inspection. The staff we interviewed were aware of their responsibilities to protect residents and deal promptly and efficiently with any allegations or suspicions of misdemeanour and to report suspicions to their line manager or Homefield House DS0000043327.V364276.R01.S.doc Version 5.2 Page 15 use the whistle blowing procedures to report outside their organisation to agencies such as the Commission or directly to the police. Areas of strength are positive approach to managing complaints and concerns and the positive feedback from residents but there is one matter requiring improvement. The procedures for referring allegations of abuse to the local authority care management team; refresher training is already booked and the Commission is confident this training and guidance will be acted upon if the need arises. So this section, about complaints and protection, is assessed as good. Homefield House DS0000043327.V364276.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): NMS 19 and 26: People using this service experience good quality outcome in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a safe, well-maintained and comfortable environment. It was clean and comfortably warm at the time of inspection. EVIDENCE: This is a purpose built care home with a wide range of communal rooms and a variety of bedrooms of different sizes (although none of the bedrooms have ensuite toilets). The home is maintained safely and no hazards were identified in the general environment. A recommendation was made to replace furniture that is old and worn or that it should be repaired or replaced for example armchair covers were very worn. This has been attended to and the overall impression was of a reasonably well maintained care home. This home cares for people who have recently been in hospital and are preparing to return home so their conditions vary from considerable immobility and dependency to greater mobility and independence. The home has in place a range of facilities to support this including various aids and adaptations such Homefield House DS0000043327.V364276.R01.S.doc Version 5.2 Page 17 as a domestic scale kitchen on the first floor for retraining domestic skills and aids in the toilets and bathrooms to ensure the safety of residents. The bedroom doors have been replaced with suitable fire doors. The locks we saw last year were not suitable, they were neither safe nor provided adequate privacy, these have now been replaced with more suitable ‘Yale-type’ locks. We noted that hoists are available to support residents when moving and transferring. Assisted baths are available and the home has a passenger lift. It is therefore well equipped for residents who are less mobile. We discussed the availability of pressure-relieving mattresses with a visiting Nurse; whilst the use of fleece is now a little out-dated it can still be used as first line of defence against skin damage but the Nurses told us that alternating air-pressure mattress can be supplied for residents if the need arises. Areas of strength are homeliness of what is very large care home and matters recommended for improvement include the need to replace some furniture. This is a safe and well maintained and well equipped building so this section, about the environment, is assessed as good. Homefield House DS0000043327.V364276.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): NMS 27 to 30: People using this service experience good quality outcome in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents can be assured that staffing arrangements in the home are suitable and adequate to meet their needs. EVIDENCE: The home is currently not equipped for, and staff are not trained for, specialist forms of care such as dementia care and nursing care because these fall outside its registration category. The home is however considering a review of registration so as to extend registration to include dementia care. An application to vary its registration will be required before such changes in care can be undertaken by the home. The training programme is very good and includes a wide range of opportunities, including basic elements such as fire safety and ‘moving and handling’ (residents) and important issues such as protecting elders from abuse. Arrangements for staff supervision are in place the manager said, but this was not always clear in the staff files and staff in charge on the day confirmed that this area is still not right. Regular staff meetings are being held. Staff are given training in matters of safety such as handling chemicals, fire safety and maintaining a safe environment. Housekeeping staff, those that do the cooking and cleaning, are employed by a private company contracted to provide these services to the home; the person in charge does not therefore have full control of the staff team nor some aspects of the running of the home such the cleaning of the kitchen; preparation of menus and kitchen records; training and supervision of Homefield House DS0000043327.V364276.R01.S.doc Version 5.2 Page 19 housekeeping staff and so on. This is a matter the Commission will keep under review. It is noted that in the feedback to the Commission residents very much appreciate the care provided by staff but they are concerned about the many temporary staff they see. The Commission was advised there are typically 50 agency staff on duty as there was on the day of inspection. Again it was noted during the visit in September 2007 that this home still regularly relies upon agency care staff. Whilst some are long term agency staff and therefore familiar with residents’ needs the residents tell us that this is not always the case – residents infer this by telling us that “the permanent staff are very good”, and asked if staff are always available they report that, “Usually, except when agency staff (are on duty), then it can be difficult”. We are advised that the manager has been given permission to recruit more permanent staff. Areas of strength are the very caring manner in which staff go about their duties and the substantial support and training provided by the LB Croydon for staff in the home but matters requiring improvement include the need for sufficient numbers of permanent staff to be employed and for all staff to be suitably and regularly supervised. Nevertheless the overall staffing arrangements in this home are safe and sound indicating that this section, about staffing, can be assessed as good. Homefield House DS0000043327.V364276.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): NMS 31, 33, 35, 36, 37 and 38: People using this service experience good quality outcome in this area. We have made this judgement using a range of evidence, including a visit to this service. It was clear that the staff team, including the senior staff and the recently registered manager are managing the home with the intentions of providing for the best interests of the residents. Record keeping is proficient and the home appeared to be safely managed. EVIDENCE: The new but very experienced manager is in post and has recently been registered with the Commission as person ‘fit’ to manage this service. In respect of the general management of the care home the introduction of private company to manage the catering and cleaning of the home, and the staff who will undertake the work, is no longer under the direct managerial control of the Registered Manager. The providers (LB Croydon) must ensure that this will not inhibit the manager from complying with National Minimum Stands and Care Home Regulations. Homefield House DS0000043327.V364276.R01.S.doc Version 5.2 Page 21 It is the opinion of residents and visitors that this home is being run in the best interests of those services users. The home is being safely run, according to residents’ statements, by a dedicated and caring staff team. The arrangements for handling residents’ money, when handed into the office, have been checked on a number of occasions by the Commission and appear satisfactory. The home’s accounts and cash held in the home are periodically audited independently in addition to the Commission’s checks. During this inspection the manager asked for advice about residents contributing their personal allowance towards certain activities, bingo for example. Whilst clarifying those residents who have the capacity may choose to contribute it remains the case that the home is expected to provide occupation, recreation and education within the overall fee structure. Such voluntary contributions must not become an expectation as if part of the fee and the home must continue to provide an adequate level of activities whether or not residents choose to pay for ‘special’ events. A sample of records were checked including residents’ case files, staff files, menus, accident records, complaints records, visitors’ log, staff duty rosters, medication charts and so forth. Record keeping and general administration in the home is well managed, indeed residents note that, “staff are overloaded with office work”. The result is however that record keeping, such as the care plans which are an important part of their work, is well maintained. One area that does need to be clearer is the record of staff supervision; staff must receive one-to-one supervision at least six times each year and this level of support was not clear in all cases when we checked staff files. In respect of the health and safety of residents the home is well managed and no hazards were identified during this visit. Areas of strength are the high esteem in which residents hold the home and this indicates good day to day management of the home. Matters requiring improvement include the recommendations to monitor residents’ extra payments; ensure staff supervision is noted in their files; reduce use of agency staff whenever possible. This section, about administration and management, is assessed as good. Homefield House DS0000043327.V364276.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X 3 X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 2 3 3 Homefield House DS0000043327.V364276.R01.S.doc Version 5.2 Page 23 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. 1 Standard OP36 Regulation 18(2)a Requirement Staff supervision: Staff must be suitably supervised and at appropriate intervals throughout the year so that residents can be assured staff are competent to undertake their duties. Timescale for action 30/08/08 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 OP14 Good Practice Recommendations Risks and capacity of residents: It is recommended that staff are given further guidance in the application of the new Mental Capacity Act so they know how to use it in challenging situations. Homefield House DS0000043327.V364276.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG 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 Homefield House DS0000043327.V364276.R01.S.doc Version 5.2 Page 25 - 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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