Care Home: Loring Hall

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What the care home does well Records seen were well maintained and care plans were up to date. Care plans reflected resident needs and showed how these were to be met. Staff spoke respectfully about the residents and showed insight and knowledge into their needs. The home had access to a mini-bus, which helped with outings and transportation, in general, for the residents. Attention was given to ensuring the environment and equipment provided was safely maintained. All bedrooms were used for single occupancy, which afforded the residents privacy. What has improved since the last inspection? Three out of five requirements made at the previous inspection had been complied with and a one largely met. What the care home could do better: The manager must ensure that an updated Service user Guide is produced in an appropriate form for service users with communication difficulties. Residents Reviews must be held six monthly. In the event of relatives/advocates/professionals not being able to attend this should be recorded and review undertaken by staff members and the resident. All recommendations made in the Pharmacist audit report must be implemented promptly. The manager must ensure that surveys of the views of residents regarding the quality of the service provided are conducted annually and made public along with other surveys of the views of relatives and external professionals. Monthly care summaries compiled by key workers should be reintroduced. The standard of recording /description within the daily diaries should be improved (as discussed with the manager) Prospective staff should ensure their details of employment history are accurate and management should obtain explanation of any gaps and verify this on the form. Staff should be pro active in ensuring relatives are kept up to date with how residents are. Staff should be pro active in ensuring relatives are kept up to date with how residents are. CARE HOME ADULTS 18-65 Loring Hall 8 Water Lane Bexley Kent DA14 5ES Lead Inspector Keith Izzard Unannounced Inspection 18 December 2007 09:15 th Loring Hall DS0000051557.V350985.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 Loring Hall DS0000051557.V350985.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. Loring Hall DS0000051557.V350985.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Loring Hall Address 8 Water Lane Bexley Kent DA14 5ES 020 8302 9302 020 8302 8686 johnp@oakfields.net 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) Oakfields Care Ltd Mr John Parker Care Home 16 Category(ies) of Learning disability (15), Learning disability over registration, with number 65 years of age (1) of places Loring Hall DS0000051557.V350985.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 1 place registered for category LD(E) relates to named service user only. 28th February 2007 Date of last inspection Brief Description of the Service: Loring Hall is a large two storey, listed building set in spacious grounds. The home was registered on 27th February 2004 to provide long term care for sixteen residents who have a learning disability. At the time of inspection the home was just over half full, having accommodated eleven residents. The property is very well furnished and the accommodation of a high standard. All service user rooms are single and have en suite facilities. The home is split into two self- contained units with a potential for eight service users to occupy each of the units on the ground and first floors. There are other communal areas within the building that allow for a range of occupational and recreational facilities in addition to the individual units. The existing management team has a good level of experience in learning disability and a good level of training is provided for care staff, all those in post either have or are undergoing NVQ level 2 training. The range of activities for service users is extensive and the grounds offer considerable potential for occupational therapy and to develop work skills. The current fees for the home range between £1600-£2500 per week. Loring Hall DS0000051557.V350985.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The site visit for this unannounced inspection was completed over 8.5 hours 18/12/07. Four members of staff and the manager assisted the Inspector. All the residents were seen in the home as all eleven, currently accommodated were at home on the days of inspection. The service was last inspected in December 2006. The inspection included a review of information received about the service, a tour of the premises, inspection of records, talking to and observing residents’ interaction with members of the staff team. Following the inspection contact was made with relatives and other interested parties to get their views of the service. These were all positive except some relatives stated they would appreciate more contact from staff to update them on progress made by residents. There was a happy and positive atmosphere in the home on the days of inspection and residents appeared well cared for by staff members who were observed to be both caring and professional in their approach with residents. What the service does well: Records seen were well maintained and care plans were up to date. Care plans reflected resident needs and showed how these were to be met. Staff spoke respectfully about the residents and showed insight and knowledge into their needs. The home had access to a mini-bus, which helped with outings and transportation, in general, for the residents. Attention was given to ensuring the environment and equipment provided was safely maintained. All bedrooms were used for single occupancy, which afforded the residents privacy. Loring Hall DS0000051557.V350985.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Loring Hall DS0000051557.V350985.R01.S.doc Version 5.2 Page 7 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 Loring Hall DS0000051557.V350985.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1&2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Statement of Purpose has been updated but the Service User Guide must be produced in a suitable format for those with communication difficulties. Prospective service users’ needs are comprehensively assessed EVIDENCE: Standard 1 A requirement was madder at the previous inspection on 06/12/06 that the Service User Guide must be produced in a suitable format for those service users with communication difficulties. Although this has been completed in respect of the complaints procedure the rest of the document has yet to be completed and therefore this requirement is restated. See Restated Requirement 1 Standard 2 We viewed the two most recent admission assessments in residents’ care plans, and these were very detailed, and showed that sufficient information was recorded before a decision was made to offer a placement to the resident. Loring Hall DS0000051557.V350985.R01.S.doc Version 5.2 Page 9 The assessments indicated that information was taken in regards to different aspects of daily living, communication needs, and social preferences, and included health needs and evidence of assessing compatibility with other service users. Loring Hall DS0000051557.V350985.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans and risk assessments viewed were up to date, comprehensive and reviewed on a regular basis and showed that residents were involved and family or representatives and professionals involved had been invited. Residents were involved in decisions about them, supported to be as independent as possible and records about them were handled appropriately to maintain confidentiality. EVIDENCE: Standard 6 Two care files and individual plans were examined in respect of service users. Individual plans were comprehensive and involved service users and their representatives, including family or advocates and other professionals Loring Hall DS0000051557.V350985.R01.S.doc Version 5.2 Page 11 involved. These plans are reviewed with outcomes clearly stated and agreed by all participants. The two records seen were comprehensive and up to date, however they were not signed either by the resident/advocate or the manager, this must occur. In respect of other residents the manager confirmed that not all are reviewed on a six monthly basis. In the absence of agreement by relatives or external involved professionals the home should conduct its own internal six monthly review and retain evidence that relatives and relatives were invited to attend See Requirement 2 Residents’ records included risk assessments. In view of the dependency level of some of the residents in the home staff to assist them with all aspects of daily living. Where risks were identified procedures and care plans reflected how these were being managed. Additionally, clinical meetings with CLDT are also taking place when specialist individual support with complex health problems are dealt with. Standard 7 Care provided for two residents was tracked through care plans and other documents such as daily diaries and the communication book used by staff members. It was noted that monthly summaries by key workers had fallen into abeyance and it us recommended these be reinstated also that daily diary notes were sometimes lacking in content, the manager agreed to improve these areas. See Recommendation 1 In all, three service users were interviewed, two who were able to communicate well, said they were involved with decisions affecting their lives and staff members encourage them to give their views. Interaction between staff and service users, observed by the Inspector, demonstrated choice being encouraged by staff members in relation to the activities that service users were engaging in. The level of communication difficulties of some service users is such that staff members find it very difficult to meaningfully engage service users in participating in the running of the home and contribute to policies and procedures, a requirement was made at the previous inspection that surveys of residents, relatives and involved professionals must be conducted annually. This had not been completed in respect of residents and the manager acknowledged that this had been linked to the delay in producing a suitable Service User Guide referred to in Standard 1,also, please see Standard 39. See Restated Requirement 4 On a daily basis staff do make attempts to involve service users and this was evidenced in the daily diaries, the activities file and within tasks for staff listed in their shift plans. Three staff members interviewed said they endeavoured to involve residents in decision making based on their individual communication and comprehension. This is inevitably restricted by the severe communication difficulties of some of the residents and depends heavily on staff interpretation and historical knowledge of residents likes and dislikes. Staff members were observed Loring Hall DS0000051557.V350985.R01.S.doc Version 5.2 Page 12 communicating with residents and involving them in whatever was going on in a professional and caring manner. Standard 9 Risk assessments were undertaken with resident involvement and records showed clearly how risks were managed. They had been updated on a regular basis and assessments are readily available for all staff members including newer staff who may be less familiar with service user’s needs. Any restrictions placed are few and would be for the safety and welfare of service users, for example not leaving the home unaccompanied. Evidence was available from the service user’s records examined that they are enabled to express choice in what they do and staff record these occasions. Loring Hall DS0000051557.V350985.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): 11-17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Activities are resident led and the approach to them from staff members is both relaxed and empowering to the residents. Residents receive a varied and nutritional diet. EVIDENCE: Standard 11 None of the residents has been assessed as being able to sustain full time employment and none attend local day centres, however, the provision of occupational activities was subject to a recommendation made at the previous inspection. The manager has assessed who might benefit from day centre type activities and has written to Bexley Council in requesting places for a number of service users. This will now be subject to a panel decision and require some Loring Hall DS0000051557.V350985.R01.S.doc Version 5.2 Page 14 negotiation with the placing authorities in respect of obtaining suitable funding should placements become available. Standard 12, 13 &14 Evidence was available from the care files of service users that opportunities are being made available for the personal development of residents. An activities folder records what activities are provided for individual service users. Evidence was available that a good range of fulfilling activities and outings are provided from the care records examined and from resident’s comments received. The home has established contact with two local colleges and some service users attend arts and crafts activities and music and movement and for one cookery. Other activities include music sessions in house, gym sessions, horse riding, confidence building, dancing, bowling and visits to places of interest. Of particular note, was a training session recently organised by a qualified artist when all residents had produced their own work and the results displayed near the manager’s office. The individual work was of a very high standard and residents are to be congratulated for their efforts. A visiting Psychiatrist had also found the work interesting and in some instances of interpretive value. The manager hopes to provide further sessions in order to build upon the success achieved by the residents. Standard 15 Staff members actively support and encourage family contact but two service users have no such contact and the home has made referrals for advocates but without success currently. Through the various activities and outings provided residents are provided with some opportunity for meeting with other people outside of the home, however, staff report that there are no relationships of significance for any of the residents other than their family. Appropriate risk assessments were identified in respect of expressed sexuality or vulnerability in this area, in respect of all three individual care files that were examined. Standard 16 Residents were enabled to choose their own clothes and hairstyles, when accompanied by staff members on shopping tips. Residents were also supported to choose their own decoration and personal items for their own rooms and to participate, or otherwise in activities of their own choosing. Residents were supported to maintain positive relationships with their family. One resident who did not have family had been referred to the local advocacy service and has an appointee from the placing authority to deal with his finances following representation made by the manager of the home. Loring Hall DS0000051557.V350985.R01.S.doc Version 5.2 Page 15 Standard 17 Varied and nutritious meals were provided to meet resident preferences and a rota of meals provided was seen over a period of four weeks and a good supply of both fresh and frozen food was seen stored in the home. Loring Hall DS0000051557.V350985.R01.S.doc Version 5.2 Page 16 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 &20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s personal physical and emotional needs were being met and with the involvement of the resident, as far as this, could be achieved, as some residents have communication difficulties. Medicines were assessed as safely managed on the day of inspection but some areas of managing the system require improvements. EVIDENCE: Standard 18 All bedrooms in the home are single occupancy, which provides privacy for the residents. Care plans seen showed how personal care needs were to be met. Of the three residents interviewed all were able to confirm that her needs were adequately met. All residents had completed CSCI survey questionnaires those with communication difficulties, had been assisted by their key workers. All three were very positive in their comments regarding the support they received from staff members and the service provided for them. Care plans Loring Hall DS0000051557.V350985.R01.S.doc Version 5.2 Page 17 seen showed how care needs were to be met and staff spoken with displayed a good understanding of residents’ personalities, needs and preferences in relation to how their personal care was provided. All residents were seen on the day of inspection and appeared well cared for and wearing age appropriate clothing. The individual daily diaries and communication book provided ongoing evidence of both the way in which personal care and support are provided to individual residents on a daily basis and that their physical and emotional care needs were being met. Standard 19 All residents were registered with a GP and staff supported them to access other medical services such as dental and optical care. Links were maintained with the community learning disability team to support staff with meeting service users’ needs. Care plans and daily records showed how personal care was provided. Staff interviewed spoke with knowledge and confidence about resident’s individual needs and preferences. Residents were supported to access health services appropriately and these were provided either in the home or by attendance at local clinics and surgeries. Evidence was available from care files and daily diaries in respect of service users that a wide range of health and related professionals are commissioned to attend to health needs on a regular basis, for example, Dentist, Psychiatrist, Psychologist Dietician and Speech and Language Therapist. Standard 20 The system for medication was examined and was mostly well managed. None of the service users are able to deal with their own medication and all staff members who deal with it are trained to do so and their training is recorded. All staff members who deal with medication had received recent training from the supplying Pharmacist Lloyds. Three MAR sheets were examined and recorded appropriately and tallied with the blister packs that were retained in a lockable cabinet on each unit. In response to a requirement made at the previous inspection external medication was now stored separately and a separate area/shelf within the cabinet had been provided. It was noted that medication stored in bottles and also creams have the date they were opened clearly marked on the containers. An audit of medication practice was conducted by the supplying Pharmacist on 26/10/07, overall practice was good but four recommendations were made, these must be implemented by the manager to fully meet the Standard. See Requirement 3 One resident requires a controlled drug that was separately locked away within a specific container and the manager has a specific log to record this controlled Loring Hall DS0000051557.V350985.R01.S.doc Version 5.2 Page 18 drug, it was noted that, as required, two staff members witness the giving of this drug on each occasion and both signatures are recorded to evidence this. Loring Hall DS0000051557.V350985.R01.S.doc Version 5.2 Page 19 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 &23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Adequate procedures were in place to ensure complaints were appropriately managed and to ensure protection for residents. EVIDENCE: Standard 22 The home had policies and procedures in relation to complaint management. A system was in place to record complaints made about the service. No complaints had been received by the home, nor were any submitted to the Commission since the previous inspection.. A pictorial complaints leaflet has been provided to assist any residents with communication difficulties, and will also be incorporated within the new Service user Guide when this is finalised. Standard 23 Staff members had received training on adult protection and those interviewed, displayed a good understanding and an awareness of whistle blowing procedures. Any suspicions or allegations of abuse, or unexplained injuries to residents would be referred to the Bexley Community learning disability team for investigation and to CSCI on Regulation 37 notifications. One such referral had been made just prior to the inspection, the only one since the previous inspection. The Inspector was satisfied that the correct procedures had been followed, immediately, and that the welfare of residents within the home had not been compromised. The matter was in the process of Loring Hall DS0000051557.V350985.R01.S.doc Version 5.2 Page 20 being considered by the Bexley Safeguarding Adults team and the result of their consideration will be made known to both home and CSCI. Should any matters of significance for residents arise from this they will be acted upon by the home and monitored by CSCI accordingly and reported on within the next inspection report. Accidents records were seen and were well maintained and appropriately recorded and followed up. Robust systems were in place to safely manage residents’ personal finances and none of the staff acted as appointee for a resident as this person is based in the head office of the company. The ledger and amounts held in individual wallets for residents was examined in respect of two residents and found to be accurate and accountable. Loring Hall DS0000051557.V350985.R01.S.doc Version 5.2 Page 21 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a safe environment. The home was clean and hygienic throughout. EVIDENCE: Standard 24 All areas of the home seen were clean, tidy and free of unpleasant odours. Bedrooms were nicely personalised and the home was suitable to meet the needs of the residents. Christmas decorations were being put up and it was noted that several service users had been encouraged to assist in this. Standard 30 On the days of inspection the home was clean, bright and airy and free from offensive odours throughout. Systems are in place to prevent the spread of infection. Overall, it was noted that the laundry area was satisfactory, although Loring Hall DS0000051557.V350985.R01.S.doc Version 5.2 Page 22 very cramped, with adequate equipment for dealing with soiled articles. Domestic cleaning materials are stored in a locked cupboard and COSH procedures are readily available for staff members performing domestic tasks. Loring Hall DS0000051557.V350985.R01.S.doc Version 5.2 Page 23 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34 & 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are supported and cared for by competent and qualified staff members who act as a team to meet their needs. Recruitment practice was satisfactory. EVIDENCE: Standard 32 Training records for all staff members were seen and this showed that a good level of training had been provided and was being planned for the future. Induction training had been provided for all new staff and foundation training following this. The home has already achieved well over the required minimum of 50 trained to NVQ Level 2, and any not so are completing or about to commence NVQ training. From observations made of care worker practice and the evidence of training provided for staff the Inspector felt that, overall, there was a good level of Loring Hall DS0000051557.V350985.R01.S.doc Version 5.2 Page 24 skills and experience and that those staff observed had the requisite attitudes and characteristics necessary to adequately support service users. Staff members were observed to be respectful and caring in the way they were relating to service users. It was equally evident that service users were content within their environment and responding positively to any staff interventions, such as assistance with eating, or engagement in activities. Standard 34 Three personnel files were examined for more recent staff recruited and recruitment practice was found to be in accordance with the requirements of Regulation 19 and Schedule 2 of the National Minimum Standards excepting that in some instances previous employment history should have been more fully completed by applicants and any gaps explained and verified. A previous requirement to ensure that two references are always obtained had been complied with. See Recommendation 2 Standard 35 Training records for individual staff members were seen and this showed that a good level of training had been provided and was being planned for the future. Induction training had been provided for new staff and foundation training following this. Overall, a comprehensive spread of training had been provided for staff members and included annual updates in fire training. A previous requirement to ensure that all staff members are annually updated in moving and handling had been complied with. Loring Hall DS0000051557.V350985.R01.S.doc Version 5.2 Page 25 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from a well run home. Surveys of resident’s views on the running of the home must be implemented as soon as possible and the results of all surveys made public annually. The health and welfare of service users are promoted and protected EVIDENCE: Standard 37 The Registered Manager is experienced and has the necessary NVQ4 qualification. Staff members interviewed stated that he is approachable and Loring Hall DS0000051557.V350985.R01.S.doc Version 5.2 Page 26 supportive and would not hesitate to discuss any concerns about the home or the welfare of service users with him. Communication within the home was of a good standard with team meetings held regularly and the manager, overall, complies with the requirements of Standard 37. The manager has undertaken training in order to update his own skills and knowledge. Standard 39 Regulation 26 reports are regularly completed on a monthly basis, as required and copies sent to the CSCI. The Inspector received feedback questionnaires from six service users and five staff members and four relatives. These were all positive except a general point made by relatives was for more contact to be made by staff from the home to update them. The manager acknowledged this was an area that should be addressed. See Recommendation 3 At the previous inspection a requirement was made that the home must conduct its own surveys of residents, relatives and professionals views on the running of the home must be publicly available and residents meetings introduced as soon as practicable on a regular basis. All except resident surveys have been introduced, this must now be complied with. Overall, all survey results must be made public. See Restated Requirement 4 Standard 42 A number of records to do with safety and maintenance were seen by the Inspector and were found to be up to date and well recorded. The manager confirmed that all staff had annually updated fire training. In respect of other checks the implementation of fire drills, alarm tests and checking of fire prevention equipment was recorded and up to date. A recommendation made at the previous inspection that the fire risk assessment for the building should be reviewed was complied with. Evidence, was available in the records retained that routine servicing and testing had taken place on the electric, gas and water systems and corresponded with the information provided by the manager in the Pre Inspection Questionnaire (AQAA). Loring Hall DS0000051557.V350985.R01.S.doc Version 5.2 Page 27 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 2 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 2 X 3 X LIFESTYLES Standard No Score 11 3 12 3 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 2 X X 3 X Loring Hall DS0000051557.V350985.R01.S.doc Version 5.2 Page 28 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA1 Regulation 4& Schedule 1 Requirement Timescale for action 01/04/08 2. YA6 15 3. 4. YA20 YA39 13 24 The Registered Person must ensure that an updated Service user Guide is produced in an appropriate form for service users with communication difficulties. Restated requirement as previous timescale 01/04/07 not met and must be complied with. Residents Reviews must be held six monthly. In the event of 01/03/08 relatives/advocates/professionals not being able to attend this should be recorded and review undertaken by staff members and the resident. All recommendations made in 01/03/08 the Pharmacist audit report must be implemented promptly. The Registered Person must 01/04/08 ensure that surveys of the views of residents regarding the quality of the service provided are conducted annually and made public along with other surveys of the views of relatives and external professionals. Partially Restated requirement: previous DS0000051557.V350985.R01.S.doc Version 5.2 Loring Hall Page 29 timescales of 01/06/06 & 01/04/07 not met and must be complied with. 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 YA7 Good Practice Recommendations Monthly care summaries compiled by key workers should be reintroduced. The standard of recording /description within the daily diaries should be improved (as discussed with the manager) Prospective staff should ensure their details of employment history are accurate and management should obtain explanation of any gaps and verify this on the form. Staff should be pro active in ensuring relatives are kept up to date with how residents are. 2 3 YA34 YA39 Loring Hall DS0000051557.V350985.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Sidcup Local Office River House 1 Maidstone Road Sidcup DA14 5RH 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 Loring Hall DS0000051557.V350985.R01.S.doc Version 5.2 Page 31 - 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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