Care Home: Malvern House

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What the care home does well Malvern House is owned and managed by Mr and Mrs Emmerson who have cared for a number of the residents for a large number of years and as such have a clear understanding of their needs. The staff receive appropriate training to ensure they are equipped to offer good support to individuals. The management and staff in addition to offering personal care it enables residents to have age appropriate activities of their choosing and a life style that meets their individual needs. The management team keeps up to date and well informed about current trends in the care of people with a LD (Learning Disability) ensuring people have access to all that is available within the community. The residents are enabled to have a say in the continued employment of support staff, which all staff members are aware of. This ensures that staff understand that the residents views are all important. The residents said that they are encouraged to give their opinions about the services they receive and all aspects of their support. Comments received from relatives of the residents on their completed surveys include: `They care very much about my sister and from what I observe when I visit her, the residents are equally treated.` `They get the residents involved up to the level of their individual ability` What has improved since the last inspection? Since the last inspection the registered manager has resigned from this service, which had an effect upon the people who live there. However this has been well managed by the management and staff, resulting in people being content in the care they receive. Mrs Emmerson is in day-to-day control of the home and has identified areas such as decor that needed improving. The home has a homely look and feel to it. What the care home could do better: The development of important information such as care plans and complaints procedure on audiotape would ensure all residents would be aware of their plan of care and how to complain if they were unhappy with any aspect of the service. Resident`s bedrooms are well furnished and reflect their interests and personalities. However one resident`s bedroom had an odour to it and as such the management need to ensure the cause is identified and steps taken to manage the situation for the comfort and dignity of the resident. The resident needs referring to the continence advisor who would be able to advise on the best methods of meeting his need in relation to this aspect of his life. The home has a dog that is a pet for the residents however the majority of the residents say it is a nuisance as it is always barking. It barked several times during the inspection and one resident shouted `Shut up Lucky` another said ` Shut up you`re a damn nuisance` There is a need to ensure the residents are happy with a dog. There`s a need to ensure the staffing level meets the needs of the residents. On the afternoon of this inspection only one member of staff was on duty and as such no-one was able to go out unless able to do so without support. Two people said they would have liked to go out. Extra staff were on duty for the evening to enable people to go for their regular social night at the local pub. CARE HOME ADULTS 18-65 Malvern House 139 Heysham Road Heysham Lancashire LA3 1DE Lead Inspector Mrs Jennifer Dunkeld Unannounced Inspection 17 November 2007 14:00 th Malvern House DS0000041790.V348229.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 Malvern House DS0000041790.V348229.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. Malvern House DS0000041790.V348229.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Malvern House Address 139 Heysham Road Heysham Lancashire LA3 1DE 01524 414019 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) emmercare@aol.com Mrs Brenda Christine Emmerson Mr Ronald Emmerson Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Malvern House DS0000041790.V348229.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The service can accommodate a maximum of 8 service users in the category LD (Learning Disability) 20th October 2006 Date of last inspection Brief Description of the Service: Malvern House is a small home registered with the Commission for Social Care Inspection to provide care and accommodation for up to 8 young adults who have a learning disability. The home is a situated in Heysham close to a number of facilities and amenities. All accommodation at the home is provided on a single room basis, all of the bedrooms have en-suite facilities. Care is provided on a 24-hour basis. Some of the carers have National Vocational Qualifications in care at level 2 or above. The current fees for the home are £344 to £600.50 based upon the care support needs of the individual. Malvern House DS0000041790.V348229.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This home has been inspected against the National Minimum Standards for Adults introduced in April 2002. This site visit was unannounced in that neither the residents nor the service providers and staff were aware the inspection was to take place on Saturday 17/11/07. The site visit is part of the key inspection of the home. A key inspection takes place over a period of time, and involves gathering and analysing written information, as well as visiting the home. The site visit involved; • • • • Observations of care practices Discussions with the residents Interviews with the staff and the manager. Examination of records that are required to be maintained including plans of care. Before the visit took place, we (Commission for Social Care Inspection) asked the service provider to complete an AQAA (Annual Quality Assurance Assessment) this document is required to be completed annually and reflects how the services are provided. In this report there are references to the “tracking process”, this is a method whereby the inspector focuses on a small group of residents during the site visit. All records relating to these individuals are examined. Residents are invited to discuss their experiences of the home with the inspector. A response to surveys was requested from residents, relatives, staff and visiting professionals. The comments contained in the completed surveys included: “I just want to tell the inspector I like living here” ”I love taking the dog out, I make my own choices, I’m very happy living here” “I am very happy here it’s my home” “ I am very happy here, I went abroad for 1 weeks holiday, with some other people from here. Rosie and Alan took us to Portugal and I had a great holiday” Malvern House DS0000041790.V348229.R01.S.doc Version 5.2 Page 6 “We have always found Malvern House most welcoming to ourselves and our son. There is always fun and laughter it’s a happy atmosphere. The staff are wonderful, happy, caring and professional” This visit included discussions with 5 of the residents, a member of staff and the service provider. What the service does well: What has improved since the last inspection? Malvern House DS0000041790.V348229.R01.S.doc Version 5.2 Page 7 Since the last inspection the registered manager has resigned from this service, which had an effect upon the people who live there. However this has been well managed by the management and staff, resulting in people being content in the care they receive. Mrs Emmerson is in day-to-day control of the home and has identified areas such as decor that needed improving. The home has a homely look and feel to it. What they could do better: The development of important information such as care plans and complaints procedure on audiotape would ensure all residents would be aware of their plan of care and how to complain if they were unhappy with any aspect of the service. Resident’s bedrooms are well furnished and reflect their interests and personalities. However one resident’s bedroom had an odour to it and as such the management need to ensure the cause is identified and steps taken to manage the situation for the comfort and dignity of the resident. The resident needs referring to the continence advisor who would be able to advise on the best methods of meeting his need in relation to this aspect of his life. The home has a dog that is a pet for the residents however the majority of the residents say it is a nuisance as it is always barking. It barked several times during the inspection and one resident shouted ‘Shut up Lucky’ another said ‘ Shut up you’re a damn nuisance’ There is a need to ensure the residents are happy with a dog. There’s a need to ensure the staffing level meets the needs of the residents. On the afternoon of this inspection only one member of staff was on duty and as such no-one was able to go out unless able to do so without support. Two people said they would have liked to go out. Extra staff were on duty for the evening to enable people to go for their regular social night at the local pub. Malvern House DS0000041790.V348229.R01.S.doc Version 5.2 Page 8 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. Malvern House DS0000041790.V348229.R01.S.doc Version 5.2 Page 9 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 Malvern House DS0000041790.V348229.R01.S.doc Version 5.2 Page 10 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): Standard 2 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. No-one is admitted to the home without having their needs assessed and being assured that these will be met. EVIDENCE: There is detailed information available about the home for all residents, or possible residents, which has been developed over time into a very clear and easy to read description of the services provided, and who provides them. It is available in written and pictorial format, to help the reader understand the content. This information, including the latest CSCI report, is placed in the entrance hall of the home for anyone visiting to view. Individual records are kept for each resident, and the staff discussed the way anyone new would be initially invited to visit the home and meet the residents. Malvern House DS0000041790.V348229.R01.S.doc Version 5.2 Page 11 A social work assessment would be used to help the owner decide whether the home was the right place for the new person, that the staff were able to give the right care, and that the present residents were compatible with them. Assessments were seen for three residents as part of the ‘tracking process’, and were all based on each individuals diverse needs, to make sure the right care and support is given to each person. There was information on the residents strengths, needs, personal goals, and choices on how they wanted their support to be provided. The residents, and families, were included in deciding the best care for them. The home has a robust admission procedure and an emergency admission procedure which ensures that all admissions occur in an appropriate manner. Comments received in the completed surveys from residents included: ‘My social worker helped me to find this home. I was shown around and asked if I would like to lve here and I said yes’ ‘My family showed me this home and I liked it’ ‘I had a choice of homes but I liked this best, I’m glad I came here’ I made my own choice, Brenda and Ron showed me around. I decided to move here and I settled in’ Malvern House DS0000041790.V348229.R01.S.doc Version 5.2 Page 12 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): Standards 6, 7 and 9 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. There is a system in place for identifying peoples needs. Generally, residents can make decisions on what they want to do which results in them being content in the care they receive EVIDENCE: Comments received from the residents in their completed surveys include: ‘I am happy here’ I am always busy I am hardly ever in, I come back at Tea time.’ ‘I go to college on my own as I know the buses. I go out and about whenever I want’ Malvern House DS0000041790.V348229.R01.S.doc Version 5.2 Page 13 ‘When I first came here, I could do most things, get about on my own, go places. But now I am limited because my mobility is not the same’ The care plans viewed as part of the ‘tracking process’ have been reviewed and generally reflect the needs of the individual. However one resident’s bedroom had an odour to it and as such the management need to ensure the cause is identified and steps taken to manage the situation for the comfort and dignity of the resident. The resident needs referring to the continence advisor who would be able to advise on the best methods of meeting his need in relation to this aspect of his life. From the conversation I had with this person he is embarrassed about his condition. He also explained how he spends a lot of time sat down due to his physical condition and decreased mobility. He stated that his ‘bottom sometimes feels sore with sitting.’ The community Occupational Therapist might be able to advise on equipment that would relieve the pressure on his buttock. These aspects of his life should be reflected in his care plan. His Key worker has designed a daily routine for the man and is endeavouring to make sure all staff follow this. Staff need to be aware, for the dignity of the resident, that incontinence pads that are not fully placed inside the disposal unit will leave the room with an odour. One resident stated he would like to go out more often but said he needed assistance to go out unless in the immediate vicinity. This also needs addressing as part of his care plan. Another resident said she is happy at this home and said she has a hairdresser do her hair. The hairdresser comes to the home. She said she chooses when she wants to get up. Her care plan addressed her needs well including her mobility needs. One man explained he goes out with staff but he would like to go to the library on his own. Perhaps staff could escort him to the library, and then leave him to look around on his own. This man when younger went about unescorted and was capable of doing so. It must be difficult for him to come to terms with his change of ability. There is a need to ensure people have their total needs assessed and plans put in action to address those needs. Malvern House DS0000041790.V348229.R01.S.doc Version 5.2 Page 14 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): Standards 12, 13, 15, 16 and 17 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. In general residents can choose from a variety of activities to help develop their skills. But for some people the right level of staff support is needed to ensure daily routines promote independence. EVIDENCE: The following comments were included in the completed surveys from the people who live in the home: ‘Sometimes I make decisions in what I do each day but I need help and support to do most things’ Malvern House DS0000041790.V348229.R01.S.doc Version 5.2 Page 15 ‘I am very happy with what I do. I go to college some days. In the evenings I visit friends or go to the local pub’ ‘We go to the pub and if I want to go somewhere special I can. I went to London with one of the carers’ ‘I enjoy going out for walks with staff pushing my wheelchair’ ‘On a Saturday we all go to the pub and we can dance and listen to a group singing. I like Saturday nights’ It would appear that people who don’t need staff support to go out, have a more fulfilling lifestyle than those who need assistance to go out of the home for socialising or window shopping. Their care plan needs to reflect their needs and the staffing level to meet those needs. The management have a duty to ensure people’s needs are met. Resident’s families and friends are able to visit when they choose. The completed surveys received from families included the following comments: ‘We visit my brother regularly and the home gets in touch if need be or our relative will phone us with staff help.’ ‘I observe good care being given when I visit my friend, she is very happy there.’ ‘They always involve me with any decisions about my brother.’ Each resident is offered a key to their own bedroom door ensuring his or her privacy is respected. During the visit we observed meals were well presented and at a time to suit the individual. The dining room is a pleasant environment, table well presented with condiments as required. One man was having a late brunch as he’d had a lie-in. The residents stated they choose what goes on the menus, but if we don’t like something they would make us something else. People are weighed on a regular basis to monitor weight ensuring people are not losing or gaining weight without choosing to do so. Malvern House DS0000041790.V348229.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): Standards 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. The staff have a good understanding of the resident’s support needs. The medication at this home is well managed, promoting good health. EVIDENCE: During this visit we observed the administration of medication to one man. This was done in a professional manner with all consideration shown to the resident. Staff helping with the administration of medication had attended a medication awareness course. The records were all correct and up to date on records printed by the pharmacist with the medication taken by the residents. One resident who was case tracked had increasing physical disabilities which the service providers had ensured could be met in the home by making adaptations to the home as necessary, such as a gradually sloping ramp to the Malvern House DS0000041790.V348229.R01.S.doc Version 5.2 Page 17 front door and a specific type of en suite bathroom. The staff were well aware of this residents needs and of her plan of care. Another resident who was case tracked had lived with his parents for a large part of his life before moving to a care home from where he had moved to a nursing home due to physical ill health. Since then he has moved to this home and has settled well. he spoke of his interests and the staff support he receives. He has happy memories of his childhood and early years as a man and enjoys talking about these. The staff were aware of this and regularly listen to him reminisce. This resident said that he is enabled to go to the Doctor when he needs to. When asked he stated that his health care needs are well met and that he is happy in the home. The residents individual plans of care have a detailed record of all professional visits, such as Doctor, Dentist, Chiropodist, Psychiatrist and the District Nurse where appropriate. When assessed as requiring staff support to attend medical appointments this is provided. The surveys received from relatives of the residents included the following comments: ‘The staff make sure my brother has everything he needs to ensure he is kept well.’ ‘Appointments are made if my sister isn’t well. They care for her very well.’ The residents told us that they soon get help to go to the Doctor if they are not well. The Community Occupational therapist has been involved in the past; advising re equipment for one man who has increased impaired mobility. It would appear he would benefit from some further advice in relation to the discomfort he gets when sitting for prolonged periods of time. This man may also benefit from some input from the continence advisor. Malvern House DS0000041790.V348229.R01.S.doc Version 5.2 Page 18 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): Standards 22 and 23 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents are confident their concerns will be listened to and acted upon.Staff have an understanding of Adult Protection issues, which protect residents from abuse. EVIDENCE: There is a complaints procedure in place, with a complaints book to record any complaints, which may come to the manager’s attention. All the residents and/or their family receive a copy of the home’s complaints procedure, which is contained in the homes Statement of Purpose. Staff receive LDAF Learning Disability Award framework training in relation to the protection/safeguarding of vulnerable people. The staff spoken with were aware of what to do should an allegation of abuse be made. Residents spoken to said they would tell the staff or Brenda and Ron (service providers) if they did not like something or were worried about anything. Staff said that they would note any changes in mood of residents, which would indicate that they were not happy about something, and would try to find out what it was and put it right. Malvern House DS0000041790.V348229.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24 and 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 homely, comfortable and safe environment that meets their individual and collective needs. EVIDENCE: Resident’s bedrooms are well furnished and reflect their interests and personalities. However one resident’s bedroom had an odour to it and as such the management need to ensure the cause is identified and steps taken to manage the situation for the comfort and dignity of the resident. The ramp to the front of the home gives equalty of access for people with walking difficulties and wheel chair users. Malvern House DS0000041790.V348229.R01.S.doc Version 5.2 Page 20 There are two large lounges in the home and people freely choose where they would like to sit. Self closing devices have been installed so that doors can be held open when necessary but will automatically close should the fire alarm be sounded. Since the last inspection in 2006 the homes lounge/dining room has been redecorated. It is well furnished and has new carpet, plus a new TV and DVD player much to the residents’ pleasure. One resident said ‘Ronnie (Mr Emmerson) bought us the TV and DVD player and set it up for us. He bought us a selection of DVD’s too.’ The residents said they like their home and that they can freely move around from room to room. We saw one man helping in the kitchen which he thoroughly enjoys doing. He wore a mans apron and was proud of helping. Malvern House DS0000041790.V348229.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 32, 34 and 35. Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. The home operates a good recruitment policy, which should ensure that only people who are suitable for this type of work are offered an appointment. However the staffing level doesn’t always meet the needs of the residents. EVIDENCE: The homes recruitment process is robust. 3 Staff files were viewed during this inspection; these reflected that appropriate checks such as 2 written references and CRB (Criminal Record Bureau) clearance are taken up prior to the person commencing employment. This practice ensures that only people suitable to care for the residents are employed in the home. Upon arrival at the home we observed one member of staff stepping outside the home to have a cigarette break, we discovered that she was the only member of staff on duty. At our request she contacted the provider who arrived a short while later. Malvern House DS0000041790.V348229.R01.S.doc Version 5.2 Page 22 The needs of the residents are diverse and a number of people require assistance to go out of the home. The provision of one member of staff meant that some people could not go out. One man explained that he would like to go out but he knew he couldn’t as the staff member was ‘on her own’. When we discussed this with Mrs Emmerson the service provider, it was explained that extra staff were on duty in the evening to enable the residents to go for their Saturday night out. The service must be able to meet the needs of the residents at all times. The staff rota did not reflect the hours worked by the management; this was discussed with the provider. Management hours should be recorded on rota to evidence that the home is effectively managed. We looked at the staff training record this included the following: TOPPS induction Learning Disability Award Framework Induction Learning Disability Award Framework Foundation First Aid Moving and Handling Fire Safety Food Hygiene Medication Awareness 75 of the staff have achieved National Vocational Qualification in Care at level 2 or above. Staff also have in- house training re ‘financial procedures’ The residents said that they liked the staff; they said ‘ Bernie is nice’ and ‘She is always good to us’ ‘Comments received in the surveys included: ‘All the staff listen to what I say’ ‘The staff are good they help me to shower and shave each day’ Malvern House DS0000041790.V348229.R01.S.doc Version 5.2 Page 23 ‘The staff help me and I am very happy here.’ ‘The staff listen and do things for me’ ‘The staff are usually able to help me’ During this visit we asked this resident why the word usually was used. The answer was ‘when there are enough staff on duty’ Malvern House DS0000041790.V348229.R01.S.doc Version 5.2 Page 24 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): Standards 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. Systems and practices in the home promote and safeguard the health, safety and welfare of the people using the service. EVIDENCE: Appropriate fire precautions are taken with a fire alarm system, and extinguishers. all of which are checked regularly. All staff are instructed on what to do in case of fire, with regular fire drills. Malvern House DS0000041790.V348229.R01.S.doc Version 5.2 Page 25 The management stated that the residents’ are encouraged to manage their own finances whenever this is possible. However some people due to their disability are unable to understand their finances. The management keep individual records of all transactions. The money is securely stored, the Key Holder person in charge, signs all transactions. It is recommended that all transactions be signed by two people to protect all parties and ensure balances are correct. The record seen reflected that one resident had drawn £110 in 4 days, over 3 transactions. The record merely stated ‘given to---‘ and the name of resident. As the record is maintained for people who lack capacity to understand their finances, it is important to be explicit about the purpose of the transaction. Clear guidance has been given on how to keep a ‘record of money held on behalf of a resident’ As outlined under the previous section of this report, it is necessary to ensure the management hours are on the staff rota to reflect the home is effectively managed. One resident’s relative stated in a survey, in relation to the home, ‘When you are at the top you can’t get better’ Comments in staff surveys included the following: I feel I can always talk to my manager and that I have great support and anything I am not confident with I know that they will help me and talk it through.’ ‘This service more than any other I have worked in, provide a friendly warm atmosphere.’ The staff on duty stated that the home is well managed and that they all try to wotk together to meet the needs of the residents. Malvern House DS0000041790.V348229.R01.S.doc Version 5.2 Page 26 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 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 2 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 X 12 2 13 2 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Malvern House DS0000041790.V348229.R01.S.doc Version 5.2 Page 27 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. 3. Standard YA6 YA33 YA30 Regulation 15(2)(a) 18(1)(a) 23(2)(d) Requirement Care plans must reflect the changing needs of the residents The staffing level must meet the needs of the residents at all times. The home must be kept clean including the eradication of odours to ensure the residents dignity is upheld. The record of money held on behalf of the residents must be explicit in outlining expenditure and include two signatures for all transactions. Timescale for action 31/12/07 31/12/07 31/12/07 4. YA23 17(2) and schedule 4 31/12/07 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 YA6 Good Practice Recommendations Residents’ care plans should be developed in audio and/or video format. Malvern House DS0000041790.V348229.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Lancashire Area Office Unit 1 Tustin Court Portway Preston PR2 2YQ 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 Malvern House DS0000041790.V348229.R01.S.doc Version 5.2 Page 29 - 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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