Care Home: Orchard Close (2&3)

What the care home does well Provides a homely environment for its service users. Involves service users in life in the home as well as promoting their independence. Enables them to access health care facilities including specialist resources e.g. mental health services. Maintains strong connections where possible with friends and family. Works well towards improving the quality of services provided to individuals with mental health problems. What has improved since the last inspection? Service user plans were updated, as were risk assessments. These documents were used more as working tools and were reflective of meeting the needs of the service user group. More importantly an assessment of the environment by a specialist, was made. This action ensures that service users changing needs, as they grow older would be more safely met. CARE HOME ADULTS 18-65 Orchard Close (2&3) 2 & 3 Orchard Close, Rodney Road Wanstead London E11 2DH Lead Inspector Stanley Phipps Unannounced Inspection 11th July 2008 13:30 Orchard Close (2&3) DS0000025913.V367019.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 Orchard Close (2&3) DS0000025913.V367019.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. Orchard Close (2&3) DS0000025913.V367019.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Orchard Close (2&3) Address 2 & 3 Orchard Close, Rodney Road Wanstead London E11 2DH 020 8518 8261 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) www.rchl.org.uk Redbridge Community Housing Limited [RCHL] VACANT Care Home 14 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (14) of places Orchard Close (2&3) DS0000025913.V367019.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care Home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: 2. Mental Disorder, excluding learning disability or dementia - Code MD The maximum number of service users who can be accommodated is: 14 10th November 2006 Date of last inspection Brief Description of the Service: Orchard Close (2&3) is a care home providing personal care and accommodation for up to fourteen adults with mental health support needs. It caters for service users - both male and female. The service is owned and managed by Redbridge Community Housing Limited and is located in a quiet residential area of Wanstead in the London Borough of Redbridge. It is also close to some small local shops and a bus route. The home was opened in March 1991 and comprises two houses that are adjacent to each other, but managed as one service. All bedrooms are single occupancy. Orchard Close (2&3) is by staffed on a twenty-four hour basis and work is carried out closely with service users in developing their; personal/living skills, confidence and self esteem. Particular emphasis is put on increasing service user’s presence in community living. It is run by a newly appointed manager, two senior support workers - one based in each house and support workers. The service is geared towards enabling each service user to access healthcare, leisure, spiritual and recreational pursuits in line with their individual choices. Most of the service users have been in the home for a considerable period of Orchard Close (2&3) DS0000025913.V367019.R01.S.doc Version 5.2 Page 5 time and have grown older, with up to five individuals currently over the age of sixty-five. The registered persons have recognised that whilst every effort is made to provide a ‘home for life’ - this would depend on their ability to meet service users needs. A statement of purpose is available to all service users and a copy of the service users guide is each individual. Fees are range from £62.35 to £117.05 per week. Service users pay additional for toiletries, holidays and hairdressing - the prices of which are all variable. Orchard Close (2&3) DS0000025913.V367019.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. The inspection was unannounced and was carried out on the 11/07/08. At the time of the visit the newly appointed manager was on site and so was involved throughout the inspection process. There were twelve residents in the home, most of whom looked settled and comfortable in their home environment. Up to seventy-five percent of service users participated in the inspection process along with over eighty-five percent of the staff working in the home. The atmosphere felt extremely positive throughout the course of the visit. An assessment of medication practice, menus, policies and procedures, records required by regulation, residents’ care plans and the environment was undertaken. Discussions were held with the manager and several members of staff. The inspection also considered: information provided in the Annual Quality Assurance Assessment (AQAA) provided by the previously registered manager, verbal feedback from external professionals, along with comment cards that were returned from staff and residents. The outcomes for service users remained positive, as the management and staff at Orchard Close continued to make improvements to the service as a whole. To this end the registered persons complied with the three previously set requirements, which is positive. What the service does well: What has improved since the last inspection? Orchard Close (2&3) DS0000025913.V367019.R01.S.doc Version 5.2 Page 7 Service user plans were updated, as were risk assessments. These documents were used more as working tools and were reflective of meeting the needs of the service user group. More importantly an assessment of the environment by a specialist, was made. This action ensures that service users changing needs, as they grow older would be more safely met. 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. Orchard Close (2&3) DS0000025913.V367019.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Orchard Close (2&3) DS0000025913.V367019.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): (2) People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. Service users benefit by having detailed assessments carried out on them and have opportunities to view the service before deciding to live at Orchard Close. EVIDENCE: At the time of the inspection, there were no additions to the residents living in the home and such the assessment and admission practices were not used. However, random files were selected from the current resident group and it was clear that each individual has a thorough assessment prior to agreeing to live at Orchard Close. There was also evidence that assessment summaries were obtained from referring authorities. Given the clear processes in place,, there is little room for service users to be move into Orchard Close without the home being satisfied that they could provide for the needs of the individual. The admissions process is robust and protects prospective service users from being inappropriately placed. Orchard Close (2&3) DS0000025913.V367019.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) People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. Improvements in care planning now ensure that service users benefit from having their needs (including their specialist needs), reflected and reviewed in their individual plan. There was evidence that they take decisions with support, and maintain their safety and independence within a risk management framework. EVIDENCE: From the care plans viewed, it was clear that improvements had been made (House 2) to the quality of care planning in the home. They were updated and reflective of the needs of each of the case examined. Service users are involved in planning their care, which ensures that they are not only aware, but accept responsibility for their direction. As part of this arrangement, they have the benefit of a key worker who works closely with them in setting up and reviewing their individual plan. Care plans are developed from the assessments carried out initially with service users. It was noted that individual profiles for service users were being developed, which would give a more detailed picture of each of the service user’s background. This is useful as it could be used to look at for e.g. how individuals communicate or even what their preferred routine is. Orchard Close (2&3) DS0000025913.V367019.R01.S.doc Version 5.2 Page 11 The needs of the service user group are quite complex and though they are fairly settled in the home, most needed some level of support to influence and communicate their needs. Staff play a major role in enabling them to make decisions about their goals and objectives, which is done through the key worker system. Staff along with the service user/s detail what goes into their care plan, which is positive. One example could be drawn from the fact that one individual chooses to go to his mum every other week and clear arrangements are in place to facilitate this objective. Service users’ meetings are held regularly and they are enabled to participate and contribute to the home’s operations. Information for e.g. complaints and activities are available to them in suitable formats, throughout the home. A system for risk assessment and risk management is in place at Orchard Close. In all cases they were linked to the service user’s care plan. Staff spoken to understood the importance of risk assessments in ensuring that both the independence and safety of service users are promoted. Linking the risk assessments to their care plans ensure that staff are knowledgeable about the needs, risks and safe management of each individual resident. Both the care plans and risk assessments were updated as a result of being regularly, which is positive. A missing person’s procedure is in place at the home. Orchard Close (2&3) DS0000025913.V367019.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): (12,13,15,16,17) People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. Service users are encouraged to participate in their community, in appropriate activities and are able to maintain and develop social and personal networks of their choosing. They are also supported to exercise their rights, which are respected and promoted by staff in the home. Orchard Close provides meals that are reflective of service users’ choice and nutritional requirements. EVIDENCE: There was evidence that service users were supported to develop and maintain their living skills however restricted they might be. This is true despite having varied levels of needs and motivation. This presents sometimes a challenge for the staff team and from observation they were aware of the challenges in providing care and support to the service users group. Service users have an individual programme of activity, which is specific to their choice and interests and all staff are required to work in accordance with this. From speaking with service users they were satisfied with how the staff supported them to participate in activities that were best suited to them. This is highlighted from one of the comments made by a service user – ‘I could do whatever I want – Orchard Close (2&3) DS0000025913.V367019.R01.S.doc Version 5.2 Page 13 I’ll get the support from the staff’. It was observed that service user meetings are a popular forum for service users to decide: what, how and why they wanted to pursue a particular activity e.g. going on day trips and holidays. Service users continue to make use of the community facilities such as the cinema, the day centres, shopping arrears, and the local parks. Most of them were familiar with the community facilities and so make good use of them and again the staff are very instrumental in enabling this. One individual stated ‘ I enjoy going to Monday clubs’. Service users receive support in a flexible manner to enable them to enjoy accessing and using the community resources. It was clear that service users were engaging with their community in an effective manner. This conclusion is supported from views of external professionals, relatives and the records viewed. This is positive. From assessing service users’ records, talking to the staff and community professionals, it was noted that service users are encouraged to develop and maintain relationships with their friends and families. Relatives are also invited to and in some cases attend social events in the home such as birthday events. Some residents also go to their relatives on short periods of leave and this is usually done in conjunction with each relative and remains a positive feature of the service. One service user commented: ‘I kook forward to going to my mom every other weekend’, which is arranged without fail. This is a strong area of the home’s operations. Service users are addressed by their preferred names and are able to choose what they wear and the times they wakeup and go to bed. Staff were observed checking with the service user in the home on the day, about her preferences around personal support. Advocacy information is made available to service users and the key worker system is used as a means of ensuring that their rights and needs are respected and provided for. It was clear from the documentation seen and the feedback provided by service users, that their rights are maintained through the level of involvement that they have in deciding what is best for them. During the course of the inspection menus along with the processes of selecting meals were assessed. On the day of the visit the plan was to have takeaway meal and the service users decided exactly what their preference was. Interestingly service users in House 2 went for the traditional ‘FISH AND CHIPS’ while Service users in House 3 chose ‘KFC’ From the menu options, it was clear that service users had choices and with staff guidance and support healthy options were also made available to service users. Staff demonstrated a good understanding of service user’s specialist dietary needs. Checks carried out indicated that there was a good supply of food and drink, which is accessible to all service users. Service users could eat where they preferred, and the mealtimes were flexible. Orchard Close (2&3) DS0000025913.V367019.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): (18,19,20) People who use the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. Service users enjoy personal support in a manner that is generally suited to them. Arrangements are in place to provide for their physical and emotional health needs, as staff continued to maintain effective links with external professionals in achieving this outcome. This is enhanced by the improved practices by staff in the handling of medication. EVIDENCE: Feedback received from all service users was positive with regard to how they received personal support, which is coordinated through the key-worker system used in the home. For many they are able to independently manage their personal care. Staff were observed throughout the course of the inspection offering personal support to individuals that needed it and this was carried out in a safe and dignified manner. It was also clear that the staff had a system for determining individuals’ preferences and dislikes, which made the relationship between them – a positive one. Service users have their individual style of dress, which was consistent with their choice, culture and personality, and this was promoted in the home. Service users are generally given good support to ensure that their health needs including their mental health needs are provided for, e.g. dentist, psychiatrist, community psychiatric nurses and opticians. From looking at the Orchard Close (2&3) DS0000025913.V367019.R01.S.doc Version 5.2 Page 15 records and staffing interviews it was clear that staff were capable of making interventions to promote the health and welfare of most of the service users in their care. Service users also have the benefit of getting support to attend their outpatients’ appointment should they require this. Feedback received from external professionals was positive about the staffing awareness of service users’ needs. Records bore evidence that all community appointments were documented as they occurred. Good support is provided in relation to the healthcare needs of service users at Orchard Close. At the time of the visit, up to three service users were handling their medication independently i.e. with minimal staff support. A sound medication policy is in place to guide staff responsible for administering medication. Medication safety is enhanced by: ensuring that staff receive training in drug administration prior to supporting service users in this area. A monthly medication audit is carried out and this practice acts as a safeguard in ensuring that mistakes/errors are identified and acted upon without undue delay. Medication storage in the home is good. There was evidence from the recording systems in the home to confirm that drugs stocks are appropriately recorded and monitored at Orchard House. Service users are therefore assured that their health care support needs are well provided for. This is a strong area of the homes operations. Orchard Close (2&3) DS0000025913.V367019.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. A satisfactory complaints procedure is in place and widely available to all service users and staff. Safeguarding adults’ practices within the home generally protects service users from abuse, EVIDENCE: A satisfactory complaints procedure is in place at the home and is made widely available in appropriate formats to all service users. Despite one service user stating that he did not know who to complain to, there was evidence that the complaints procedure is made widely available to all, as it is posted on the walls of every bedroom in the home. . Feedback received from a small sample of relatives indicated that they felt able to raise issues of concern, should they feel the need to. The complaints record was analysed and in the main, complaints were logged and dealt with in line with the home’s complaints’ procedure. Staff interviewed demonstrated a clear understanding of the importance supporting service users to raise concerns should they be unhappy about any aspect of the service. There was evidence that staff had safeguarding training and that a policy was in place to direct them on safeguarding issues. There were no safeguarding issues in the home and other aspects of the home’s operations e.g. recruitment, ensures that service users are protected from abuse. Staff interviewed had a sound knowledge of how they would deal with abuse or allegations of abuse. They also show a good understanding of how and when they would invoke the whistle blowing procedure. Service users are therefore are assured that they are protected from abuse while living at Orchard Close. Orchard Close (2&3) DS0000025913.V367019.R01.S.doc Version 5.2 Page 17 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) People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. Service users live in a clean, purpose built and suitably designed home that matches their needs and lifestyles. They enjoy using their facilities, which are homely and personal, including their shared spaces. The home is clean and hygienic and fit for its purpose. EVIDENCE: Although the inspection was unannounced, the home was clean bright and airy on the day of the inspection. The registered persons took action to ensure that the environment was safe, by carrying out an assessment on the premises. Some of the service users have lived in the home for a long time and so may require adaptations to the environment to ensure that they maintain their independence in a safe way. In House 3 for example a new walk-in shower with disability access, which service users were pleased with. The home was well maintained and remains fit for its purpose. The laundry facilities were designed to promote the service user’s independence as far as possible. It was also designed to ensure that they could develop their skills in this area. An infection control policy is in place and residents and staff are encouraged to work within this e.g. hand-washing. The Orchard Close (2&3) DS0000025913.V367019.R01.S.doc Version 5.2 Page 18 laundry equipment is designed to cater for soiled linen and appropriate arrangements were in place for maintaining them. The layout of the home is such that foul linen is well away from food preparation and so the risk of the spread of infection is minimised. Services and facilities do comply with the Water Supply Regulations 1999. It must be noted that the feedback received service user and professionals was quite positive about the cleanliness and quality of the environment. Orchard Close (2&3) DS0000025913.V367019.R01.S.doc Version 5.2 Page 19 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) People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. Service users receive care and support from a staff team that is motivated to work with them. Their welfare and best interests are promoted by ensuring that generally staffing levels do reflect their needs. Robust recruitment practices means that residents are protected from coming into contact with individuals not suited to work with them. EVIDENCE: At the time of the inspection the service operated with a manager and thirteen care staff, of which two held a senior position based in both units. Although there was a sense of calm throughout the inspection process, it is fair to say that even if a service user became anxious, staffing interventions were appropriate through reassurance and a sound sense of professionalism. From the records viewed, staff were able to make appropriate referrals to external professionals e.g. the GP and generally able to act when emergencies occur. In discussion with individual members of staff apart from knowing the service users well, they demonstrated a good understanding of their roles and responsibilities in caring and supporting the service user group. The recruitment files of the most recently recruited staff was examined and there was good evidence of the robustness in the recruitment practices undertaken by the organisation. All checks required by regulation were Orchard Close (2&3) DS0000025913.V367019.R01.S.doc Version 5.2 Page 20 undertaken prior to staff taking up duty at Orchard Close Service users are therefore assured that all staff are thoroughly screened prior to engaging with them. They are therefore more protected from the risk of coming to harm, which is a positive outcome for them. A training and development plan is in place for the staff, which generally is line with the of the service user group. This needs to be enhanced however with training that focuses on the needs of the elderly, given the relative ages of some service users. This would ensure that staff enhance their skills and knowledge with the changes and needs of individuals as they grow older. All staff have a copy of the General Social Care Council’s code of conduct. A significant number of staff have achieved a VRQ qualification in mental health. Service generally receive care and support from staff that has had good preparation to provide a good quality of care. Orchard Close (2&3) DS0000025913.V367019.R01.S.doc Version 5.2 Page 21 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) People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. Management systems are in place to provide a quality service at Orchard Close. Good quality assurance systems are implemented to enhance this. Health and safety practices within the home protect service users living at Orchard Close. EVIDENCE: The current manager started at the home in April 2008, as the previously registered manager has left the service. In discussion with her she disclosed that she has had good management experience of just under three years, prior to taking up her current position. She has acquired a qualification in the Advanced Management in Care and has started the Registered Managers Award (RMA), which she intends to continue. She has had training in the Mental Capacity Act, Dementia and Safeguarding Adults, having successfully completed NVQ Levels 2&3 in Care. To add to this both staff and service users are pleased with her management style and direction. She also advised that Orchard Close (2&3) DS0000025913.V367019.R01.S.doc Version 5.2 Page 22 she intends to apply for registration with the Commission, which would fulfil the regulatory requirement. There was evidence that quality assurance systems were implemented with the view to improving the service. This included; an internal audit of the service, regular monthly monitoring visits as required by Regulation 26 of the Care Homes Regulations 2001 and service users surveys Service users’ reviews are held regularly internally and on average a yearly review with external professionals. The organisation is very strong on including service users in directing the organisation and as such service users are invited to their (RCHL) Annual General Meetings and forums where they could have there say. Service users are therefore assured that the registered persons would take steps to monitor and develop the service in their best interests. This is a strong area of the homes operations. The health and safety file was assessed and all records on; appliance safety, fire safety and electrical safety were in order. There was evidence that staff have as part of their induction, appropriate training in health and safety. Safety signs were also appropriately displayed throughout the home and all areas of the home were safely accessible to the service users. Risk assessments were in place for all service users to ensure their safety and independence. Health and safety policies were updated and available to all staff. Orchard Close (2&3) DS0000025913.V367019.R01.S.doc Version 5.2 Page 23 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 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 3 3 x 3 3 LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 4 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 4 x 3 x 4 x x 3 x Orchard Close (2&3) DS0000025913.V367019.R01.S.doc Version 5.2 Page 24 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. Standard YA35 Regulation Requirement Timescale for action 30/11/08 18(1)(c)(i) The registered persons are required to provide training for staff that takes into consideration the needs of the older service users. This is to ensure that they are able to provide the best possible support for all service users living in the home. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Orchard Close (2&3) DS0000025913.V367019.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Orchard Close (2&3) DS0000025913.V367019.R01.S.doc Version 5.2 Page 26 - 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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