Care Home: Mapleton Community Care Centre

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What the care home does well The manager ensures that people are assessed before they move in to make sure the home can meet their needs There are clear plans about people`s care that which are discussed with people living in the home or their relatives Staff make sure that people get any medical care they need Staff at Mapleton are courteous towards people living in the home and make sure they maintain their dignity. People are well supported to make choices about their daily lives. Food in the home is appetising, healthy and plentiful. Relatives and friends receive a warm welcome to the home and support from staff if they need it. Peoples` concerns are taken seriously and acted upon. Staff know how to keep people safe. Mapleton is a safe and comfortable place to live where people have the special facilities they need The staff are well trained and have a very positive and professional attitude to their work The Registered Manager is skilful and manages the home extremely well for the benefit of people living there. What has improved since the last inspection? Work on the upper floor of the building has been completed with new furniture, carpets and bathing facilities. A new garden area with raised flower beds is near completion. New "person centred" care plans have been developed. There are more staff. What the care home could do better: Regular audits of the medication system are needed to make sure all medicines are properly accounted for. CARE HOMES FOR OLDER PEOPLE Mapleton Community Care Centre Ashburton Road Newton Abbot Devon TQ12 1RB Lead Inspector Graham Thomas Unannounced Inspection 09:30 7 November 2007 th 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 Mapleton Community Care Centre DS0000032567.V349281.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. Mapleton Community Care Centre DS0000032567.V349281.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Mapleton Community Care Centre Address Ashburton Road Newton Abbot Devon TQ12 1RB 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) 01626 353261 01626 202713 http/www.devon.gov.uk/adoption.htm Devon County Council Mrs Margaret Jean Breslan Care Home 24 Category(ies) of Dementia - over 65 years of age (24), Old age, registration, with number not falling within any other category (24), of places Physical disability over 65 years of age (24) Mapleton Community Care Centre DS0000032567.V349281.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users may be admitted from the age of 50 years. Date of last inspection 16th August 2006 Brief Description of the Service: Mapleton is a service provided by Devon County Council. At the time of this inspection, there were ongoing negotiations with an independent provider concerning the future running of the homes. Mapleton is a large detached building set back from a busy road, less than a mile from Newton Abbot town centre. The home is on a bus route and there is a general store nearby. Accommodation is spread over two floors with a shaft lift providing access to the first floor. A recent major refurbishment programme, has resulted in the increased size of several of the home’s bedrooms, general upgrading of others and some improved facilities. Although none of the bedrooms has en-suite facilities, there are adequate communal toilets within close proximity of each room. Assisted bathing and showering facilities are available as well as adapted toilet facilities. Communal space includes separate lounges where people can socialise or spend time quietly pursuing their own interests. The rear garden had been redeveloped to provide raised flower beds and comfortable seating areas. This is in addition to a large garden area at the front of the premises. A large dining room is provided on the ground floor near the home’s kitchen. A mix of longer term and respite care is provided for people with a diagnosis of dementia who may also have a physical disability. From April 2007 the home’s fees for residents have been £570.50 per week. Mapleton Community Care Centre DS0000032567.V349281.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Before the inspection, the Registered Manager returned an Annual Quality Assurance self assessment with information about the home. Questionnaires were completed and returned to us by three relatives / friends and two care managers. We (the Commission) visited the home and spent one and a half days there. During the visit we toured the premises and examined all the accommodation and facilities. We spoke with six people living at the home individually and others in small groups. Four staff were interviewed. Various issues were discussed with the Registered Manager. Two visiting relatives and a care manager were spoken with during the visit. A sample of care plans and staff records were examined as well as other records about the running of the home. We inspected the home’s system for administering medicines and discussed meal arrangements with the home’s cook. What the service does well: The manager ensures that people are assessed before they move in to make sure the home can meet their needs There are clear plans about people’s care that which are discussed with people living in the home or their relatives Staff make sure that people get any medical care they need Staff at Mapleton are courteous towards people living in the home and make sure they maintain their dignity. People are well supported to make choices about their daily lives. Food in the home is appetising, healthy and plentiful. Relatives and friends receive a warm welcome to the home and support from staff if they need it. Peoples’ concerns are taken seriously and acted upon. Staff know how to keep people safe. Mapleton is a safe and comfortable place to live where people have the special facilities they need The staff are well trained and have a very positive and professional attitude to their work The Registered Manager is skilful and manages the home extremely well for the benefit of people living there. Mapleton Community Care Centre DS0000032567.V349281.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. Mapleton Community Care Centre DS0000032567.V349281.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 Mapleton Community Care Centre DS0000032567.V349281.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): Standards 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People moving into Mapleton can feel confident that the home has made a thorough assessment to ensure their needs can be met. EVIDENCE: The files of people who had recently moved to the home were examined. These showed a thorough assessment process had taken place prior to admission. This included information gathered from care managers and other sources. Assessment information is reviewed by the home’s management to ensure that an individual’s needs can be met. The home is moving to a more specialised role in older people’s mental health. Discussion with the Registered Manager demonstrated that she was clear about the service on offer and those for whom it was intended. One care manager commented: Mapleton Community Care Centre DS0000032567.V349281.R01.S.doc Version 5.2 Page 9 “Mapleton are very strict about receiving up to date care plans from Social Services. They will never accept anyone without that” People are not admitted to the home exclusively for intermediate care. Mapleton Community Care Centre DS0000032567.V349281.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): Standards 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at Mapleton receive a good standard of personal social and health care. However, medication needs to be audited to ensure that people are receiving all their medication. EVIDENCE: In conversation with people living at the home many positive comments were received about the care received. For example, one remarked that staff were “very attentive”. The three relatives / friends who returned questionnaires all felt that the home always met the needs of people living at the home. The visitors interviewed made similarly positive comments such as “we couldn’t better this”. A sample of four care plan files was examined as well as daily records. Each was clear, well organised and provided detailed information about the individual’s needs. Regular updates and re-assessments had been made where required. Daily records were factual and clear. These showed how the various elements of the plans were being followed. Mapleton Community Care Centre DS0000032567.V349281.R01.S.doc Version 5.2 Page 11 The plans included information regarding personal and health care as well as social needs. Risk assessments such as those concerned with moving and handling were seen in the plans. All had been reviewed with the person or their representative. An example was provided of a new “person centred” care plan format which is being introduced by the home. This provides information about peoples needs in a clear, accessible and jargon-free format. There were records of visits by GPs and other health care professionals. Relatives and people living at the home confirmed that medical attention was always sought when needed. Examination of feedback received by the home as part of its quality assurance process showed a high degree of satisfaction with the home amongst healthcare professionals. Care plans contained records of both routine and specialist healthcare appointments and treatments. The system for administering medicines was examined. Medicines were held in a locked room in a locked mobile trolley that was chained to the wall. Additional security was in place for controlled drugs. Evidence was seen in staff files of training in the administration of medicines and confirmed in discussion with staff. A monitored dosage system was in use in which medicines are prepacked in the correct doses by the supplying pharmacy. Records were examined and we observed staff administering medicines. The process observed was safe and in keeping with good practice. In general, records were well maintained, accurate and up to date. However, records of the tablets supplied when compared with those used did not always tally with the number of tablets remaining. In three instances there were more tablets left than indicated in the records. It is important that there is an account of medicines to ensure that people have received the medication they need. This was discussed with the Registered Manager who undertook to conduct an immediate audit of the medication. Issues of privacy and dignity were examined in this inspection. One relative, commenting on what the home does well, stated that the home “…always treats Dad with respect, dignity. Caters for all Dad’s needs and treats him as an individual” A care manager remarked “..When I visit, my clients are always offered a private lounge area, or their room, and visitors have told me that staff always knock on doors. I have only ever seen clients treated with courtesy and dignity.” These comments were confirmed by our own observations and the comments of people living at the home with whom we spoke. During the visit one person was observed in a distressed state. Staff and the Registered Manager responded to this appropriately with patience and care whilst supporting a Mapleton Community Care Centre DS0000032567.V349281.R01.S.doc Version 5.2 Page 12 visiting relative and preserving the person’s dignity. Throughout the visit people were seen to be treated with the utmost courtesy and respect Mapleton Community Care Centre DS0000032567.V349281.R01.S.doc Version 5.2 Page 13 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): Standards 12 to 15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People living at Mapleton are very well supported to make choices and pursue the lifestyle they choose. Relatives and friends receive a warm welcome to the home and are offered excellent support to maintain their contact. EVIDENCE: During our visit people were seen following their own routines. Some had chosen to join small groups in the home’s communal areas while others had chosen to spend time alone in other lounges or their own rooms. All the relatives / friends from whom we received feedback felt that people living at the home were supported to live the life they chose. One care manager commented that “…all my clients are EMI and most have no memory and confusion, in their illness. Staff at Mapleton are excellent at anticipating clients’ needs, monitoring their well-being and generally making their lives comfortable.” There are regular activities and trips out provided and the home has a variety of relevant and interesting craft/activity materials available for resident use. Mapleton Community Care Centre DS0000032567.V349281.R01.S.doc Version 5.2 Page 14 Activities are organised by staff on request and in accordance with individual needs. People with whom we spoke were satisfied that their spiritual needs were being met and that there was access to visiting clergy. This was confirmed in the home’s records. A “comforts fund” is maintained to support activities and trips. This is supported and contributed to by staff through activities such as draws, walk and car rallies. During the visit we discussed with people living at the home and their visitors events such as Christmas Parties and other events involving relatives, friends and the local community. One care manager felt that more activities could be organised though this was not reflected in comments from relatives or people living at Mapleton. Efforts have been made to ensure equal access to facilities in the home. For example, An extra television was provided in a lounge more accessible to a wheelchair user so that he can enjoy viewing in the company of others. Facilities are available in the home for people to make private telephone calls. In conversation, relatives / friends felt that they were kept well informed and involved. All those who returned questionnaires stated that they were always kept in touch with any issues affecting their relative / friend. All commented very positively about the welcoming atmosphere in the home. Relatives stated “They (the staff) are always friendly and have a happy outlook”, and “My mother has been at Mapleton for over 10 years and I have never had cause to worry as I am always kept up to date with things. They have a lovely team spirit, long may it remain” and “Staff are always very helpful. Help him with his mobile phone when required. Manager will ring to say Dad wishes to speak to me. They also take the hand held phone to dad.” A care manager commented “Staff are very caring towards residents and their families” This was confirmed by our own observations of people arriving at the home and the support given to a distressed resident and his relative. We joined staff and residents for a lunch time meal. This was a relaxed, warm, friendly and enjoyable occasion in which staff and residents chatted and shared jokes. Discreet and sensitive assistance was given to those who required help Mapleton Community Care Centre DS0000032567.V349281.R01.S.doc Version 5.2 Page 15 with eating. People commented very positively on the quantity and quality of the food provided. On the day that we took a meal, lunch comprised of roast beef with fresh vegetables and home made Yorkshire puddings. A sweet of fresh fruit or milk jelly and cream was provided for those who wanted it. Fresh fruit was also offered. During the meal, alternatives were offered to anyone who did not want the meal. The planned evening meal was scrambled egg on toast with cakes. Vegetarian alternatives were available. There was also a white board in the kitchen showing individual preferences. The cook stated that the menu had been devised in consultation with people living at the home. This was confirmed in examination of notes of residents meetings where suggestions and comments were offered. Individual special dietary requirements were being catered for including people with diabetes and those who required pureed food. A pureed meal was seen in preparation and this was attractively presented in separate, pureed portions. A four weekly menu cycle was in operation with seasonal variations. This presented a nutritious and balanced diet. Drinks were available throughout the day. Mapleton Community Care Centre DS0000032567.V349281.R01.S.doc Version 5.2 Page 16 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People can feel confident that any concerns will be listened to and acted upon. There are suitable robust policies and procedures in place to safeguard people living at Mapleton from abuse. EVIDENCE: No complaints had been received about Mapleton in the last twelve months. The home’s complaints procedure was prominently displayed and is also contained within the home’s statement of purpose. There was also a folder with numerous letters of thanks and compliments in the home’s foyer. People living at Mapleton with whom we spoke felt confident that any concerns would be listened to and acted upon by staff and the manager. Minutes of residents meetings demonstrated that any issues raised were taken seriously and acted upon. All the relatives with whom we had contact knew how to make a complaint. One person raised an issue with us during conversation which was reported to the Registered Manager. After appropriate consultation the matter was dealt with sensitively and professionally. Staff have all attended vulnerable adults training which is regularly reviewed and updated. In conversation, staff demonstrated a very clear understanding of their responsibilities in safeguarding vulnerable adults. They also Mapleton Community Care Centre DS0000032567.V349281.R01.S.doc Version 5.2 Page 17 demonstrated their understanding of the procedure to follow to alert relevant authorities of actual or suspected abuse. Mapleton Community Care Centre DS0000032567.V349281.R01.S.doc Version 5.2 Page 18 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): Standards 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at Mapleton benefit from an environment which is comfortable, convenient, safe and well maintained. High standards of cleanliness and hygiene are maintained throughout the home EVIDENCE: All parts of the premises were examined during our visit to the home. On inspection all areas were clean, fresh and free from obvious hazards. The safety of people living on the first floor has been enhanced by an automatically closing door arrangement at the top of the main staircase. A care manager commented that the home was “kept spotless” and relatives with whom we spoke stated that the home was always clean and free from any offensive odours. Mapleton Community Care Centre DS0000032567.V349281.R01.S.doc Version 5.2 Page 19 Mapleton has benefited from a substantial recent refurbishment. This has increased the size of some individual rooms and improved some facilities in the home, for example, by widening doorways to improve access to rooms. Individual rooms do not have en suite facilities but there are numerous conveniently situated toilets around the building. Each room was comfortably furnished and decorated and personalised with possessions brought to the home. A number of lounge spaces allow for individuals to watch television, spend time with others or more quietly if they wish. Bathrooms, shower facilities and toilets were adapted to suit the needs of people with physical disabilities. Such adaptations including, for example grab rails, “Malibu” baths and raised toilet seats. People living at Mapleton and their relatives with whom we had contact were all very satisfied with the standard of accommodation. Laundry facilities are well-equipped and included sluicing and maceration facilities. The laundry rooms had cleanable walls, impermeable floors and hand washing facilities for staff. Liquid soap and paper towels were provided in the home’s toilets and bathrooms. Each room also had a ready supply of disposable gloves for staff use. Mapleton Community Care Centre DS0000032567.V349281.R01.S.doc Version 5.2 Page 20 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): Standards 27 to 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at Mapleton are supported by a well trained, highly motivated and competent staff team. Sound recruitment procedures help to ensure that people are kept safe. EVIDENCE: Many positive comments were received about the home’s staff. Particular mention was made of their attentiveness, caring attitude and positive outlook. Care managers’ comments included “They do an extremely difficult job, looking after dementia clients, and I have only ever seen the clients treated with courtesy and dignity.” , “Staff are very caring towards residents and their families”, “1. Look after dementia clients with patience, courtesy and dignity. 2. Keep the home spotless 3.There is always a welcoming atmosphere 4. Work hard to resolve problems”. A relative commented: Mapleton Community Care Centre DS0000032567.V349281.R01.S.doc Version 5.2 Page 21 “I have found the staff very sensitive, caring and genuinely interested in the welfare of the patients they have. They are always friendly and have a happy outlook which is transferred to the residents” Another stated that staff were “fantastic” Our own observations and discussion with staff indicated very high levels of motivation and commitment amongst the staff group. This was demonstrated by their personal involvement in efforts outside work time to improve the service (for example by raising money for the “comforts fund”.) One staff member commented that whilst on holiday she always missed work and looked forward to her return. Examination of the staffing arrangements and observations during the inspection showed that the home is sufficiently well staffed to meet the needs of people living in the home. Care is provided in the home by a total of 29 care staff. Additionally there are specialist catering, domestic and administrative staff. A clear organisational structure was understood by the staff and residents with whom we spoke. Over two thirds of the care staff held a National Vocational Qualification in care at level 2 or above. Two of these staff were upgrading their qualifications while two others were waiting to commence courses. All the catering staff held a National Vocational Qualification in catering at level 2 or three. There were clear training plans and staff had attended short courses relevant to their work such as moving and handling, dementia awareness and food hygiene. Examination of staff files and discussion with staff confirmed that a sound recruitment procedure was in place. This included a formal application procedure with criminal records checks, the taking up of references and interviews. Mapleton Community Care Centre DS0000032567.V349281.R01.S.doc Version 5.2 Page 22 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): Standards 31, 32, 33, 35, 37 and 38 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People living at Mapleton and its staff benefit from a professional and committed Registered Manager who has skilfully managed substantial change whilst maintaining a clear focus on the needs of people living in the home. EVIDENCE: The Registered Manager holds the Registered Manager’s Award and along with the other members of the management team undertakes regular, relevant training. Written feedback received during this inspection as well as discussion with staff, residents and relatives all indicated that the Registered Manager is well respected and popular. Mapleton Community Care Centre DS0000032567.V349281.R01.S.doc Version 5.2 Page 23 Relatives commented “In our experience we are completely satisfied. They already provide an excellent service” “I do not think at the moment of anything that can be improved”, and “From what I see the staff and management at Mapleton are doing a wonderful job” The home remains in the process of substantial change in terms of its building, organisation and the nature and needs of its residents. Motivation remains high in the staff team, people living at the home, relatives and professionals report high levels of satisfaction and confidence in the care they receive. This provides evidence that the process has been skilfully managed. The County Council’s corporate quality assurance system was being implemented at the time of this inspection. However, the home had already taken it’s own initiatives to seek people views and incorporate them into the running of the service. This commitment to continuous improvements was evident. The views of staff, residents relatives and professionals had been sought through questionnaires and meetings. Changes had been implemented on the basis of these views. Initiatives such as the new person centred care plan model place the needs of people living at Mapleton at the heart of the service. The Registered Manager was seen to act promptly and professionally to rectify any shortfalls identified during the inspection. The residents’ finances are managed in such a manner to ensure peoples’ interests are safeguarded and all monies are accounted for. There were detailed records in respect of individual’ finances. The Local Authority holds up to £50.00 for each resident (for which interest accrued is payable to residents), after which monies are banked in an individual account for each person. The standard of record keeping in the home was generally high and observation and discussion with staff demonstrated that records such as care plans were used as working documents rather than being an unrelated “paper exercise”. In discussion staff had a clear understanding of the individual needs of people living at Mapleton. Health and safety records showed that systems and equipment were being checked regularly. New checklists were being put in place concerning, for example, wheelchairs, furniture and bedrails. The Registered Manager stated that a fire risk assessment was in place and that individual evacuation plans were being developed. Staff files showed regular training and updates in such topics as first aid, infection control and moving and handling. Mapleton Community Care Centre DS0000032567.V349281.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for 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 2 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 4 3 X 3 X X 3 Mapleton Community Care Centre DS0000032567.V349281.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP9 Good Practice Recommendations The Registered Manager should conduct regular audits of the medication system to ensure that all medication is accounted for. Mapleton Community Care Centre DS0000032567.V349281.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Mapleton Community Care Centre DS0000032567.V349281.R01.S.doc Version 5.2 Page 27 - 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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