Care Home: Rainbow House (Holiday Centre)

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What the care home does well The Centre provides guests with an enjoyable holiday which includes enabling them to take part in a range of activities. The Centre is well managed by an enthusiastic Manager who puts the needs of the guests first. The Home has a deputy manager and a team of Senior care staff so that there is always a senior member of staff on duty. The care staff are clear about their purpose of providing an enjoyable holiday to the guests whilst meeting their personal and healthcare needs. The staff receive appropriate training and support to carry out their roles effectively. Relatives surveys contained the following comments: "What would we do without such wonderful, caring and helpful staff" "they are friendly, caring and professional" "provides an active, busy holiday" "they provide excellent breaks" What has improved since the last inspection? The Centre now has a consistent management team who work well together and who provide good support to the care staff. Some ongoing redecoration has taken place.Improvements have been made to the medication system so that it is now safer. Staffing levels have increased and due to the recent recruitment there is very little use of agency staff. The increased staffing levels means that guests can have more choice about how they spend their time and also means that more activities can be provided during the evenings than before. The care plans and risk assessments have improved so that they now provide detailed information for staff about how to meet the guests needs. What the care home could do better: Toiletries and cleaning products could be stored more securely. Some areas of the Centre are still in need of redecoration and refurbishment. CARE HOME ADULTS 18-65 Rainbow House (Holiday Centre) 15 Hooks Hill Road Sheringham Norfolk NR26 8NL Lead Inspector Lella Hudson Unannounced Inspection 18th February 2009 09:30 Rainbow House (Holiday Centre) DS0000027335.V374264.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 Rainbow House (Holiday Centre) DS0000027335.V374264.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. Rainbow House (Holiday Centre) DS0000027335.V374264.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rainbow House (Holiday Centre) Address 15 Hooks Hill Road Sheringham Norfolk NR26 8NL 01263 821310 01263 821310 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.break-charity.org BREAK Christine Eves Care Home 10 Category(ies) of Learning disability (10), Learning disability over registration, with number 65 years of age (10), Physical disability (10), of places Physical disability over 65 years of age (10) Rainbow House (Holiday Centre) DS0000027335.V374264.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Those accommodated with a learning or physical disability may be under the age of eighteen years. No unaccompanied child under the age of five may be accommodated. No unaccompanied individuals may be accommodated during the weeks set aside for family groups. Date of last inspection Brief Description of the Service: Rainbow House is owned and managed by the BREAK organisation which is a charity based in Norfolk and provides a variety of services to children and adults. Rainbow House (referred to throughout the report as the Centre) is a large detached house situated in a residential area of the seaside town of Sheringham. To the front of the Centre is a large, heated indoor swimming pool and an enclosed garden. The Centre provides holiday stays for children and adults with a wide range of disabilities. All guests have a single room. The bookings are arranged so that there are either groups of children or groups of adults staying at any one time. The service users are referred to throughout the report as guests. The fees for the centre are from £500 to £700 per week. organisation for more details about fees. Please contact the Rainbow House (Holiday Centre) DS0000027335.V374264.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is TWO STAR. This means that the people who use this service experience GOOD quality outcomes. This report contains information that has been gathered about the service since the last Key Inspection (January 2008). It includes information gathered during an unannounced visit to the Home on the 18th February 2009. During our visit we spoke to the Manager, staff and guests as well as looking around the Centre and looking at a selection of records. The Manager started working at the Home in December 2007 and completed the registration process with the Commission in October 2008. What the service does well: What has improved since the last inspection? The Centre now has a consistent management team who work well together and who provide good support to the care staff. Some ongoing redecoration has taken place. Rainbow House (Holiday Centre) DS0000027335.V374264.R01.S.doc Version 5.2 Page 6 Improvements have been made to the medication system so that it is now safer. Staffing levels have increased and due to the recent recruitment there is very little use of agency staff. The increased staffing levels means that guests can have more choice about how they spend their time and also means that more activities can be provided during the evenings than before. The care plans and risk assessments have improved so that they now provide detailed information for staff about how to meet the guests needs. 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. Rainbow House (Holiday Centre) DS0000027335.V374264.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Rainbow House (Holiday Centre) DS0000027335.V374264.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Information about guests needs is gathered prior to their stay. EVIDENCE: The initial information about guests needs is provided through the booking form. This asks for information about a range of needs, including mobility, behaviour, communication, personal care. Staff contact relatives /carers if they need to clarify an issue or feel that they need more information about any issues. On the day of arrival a member of staff spends time with the guest and their relative/carer to establish whether there have been any changes in the needs of guests. As guests come to the Centre from all over the country it is not practical for the Manager to individually assess each guest although guests are invited to visit the Centre prior to their stay if they wish to. The bookings co-ordinator is now based at the Centre and said that this is an improvement as she can meet the guests and it is easy to discuss any issues with staff as they are now all in the same building. One of the relatives surveys stated that “Communication with ….who takes the bookings is brilliant, she is always helpful”. Rainbow House (Holiday Centre) DS0000027335.V374264.R01.S.doc Version 5.2 Page 9 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, 8 & 9 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service The care plans and risk assessments provide good information to staff about how to meet guests needs. The guests are involved in planning their holiday. EVIDENCE: In the last three years the quality of the care plans and risk assessments has greatly improved. We looked at two of the guests care plans during our visit to the Centre and these contain detailed information about the guests needs and how these should be met. There is a particularly useful section asking for information about how guests communicate different feelings, such as being worried, bored or angry. This is particularly helpful for staff when supporting guests whose verbal communication is limited. The staff and bookings co-ordinator encourage the relatives/carers to provide as much information to them as possible so as to be able to meet the guests needs and to provide them with an enjoyable holiday. Rainbow House (Holiday Centre) DS0000027335.V374264.R01.S.doc Version 5.2 Page 10 The bookings co-ordinator uses a risk assessment approach to booking guests which has improved the compatibility of guests staying at the Centre at any one time. Discussions with staff show that this has greatly improved although there are still some times when the mix is not ideal. They said that this may sometimes be caused by guests just not getting on together and that they can then make sure that these guests do not have their holidays at the same time in future. The senior care staff are responsible for carrying out risk assessments for the guests and these are completed prior to their stay and then updated during the guests stay if necessary. One of the senior staff also completes a brief guide to the needs of the guests so that staff have this as a quick reference as well as reading the care plans. Staff sign to confirm that they have read the care plans for the forthcoming guests. The staffing levels have been increased since the last Inspection and staff said that this makes a big difference to the quality of the holidays that they can provide to guests. This is particularly true when the guests want to do different things as there are now enough staff to support small groups of guests in different activities. One of the members of staff has undertaken the Communication Co-ordinators course and is responsible for identifying areas where communication can be improved. A new Service User Guide has been produced using photographs which is easier for some guests to understand. The Centre has a photograph board which shows which staff are on duty for that day. Photographs are used on the front of the cupboards in the dining room to show what is kept in each cupboard. The staff who spoke to us were clear about the importance of providing an enjoyable holiday for guests. They said that due to the increased staffing they are more able to ensure that guests have a choice about what they do. They are also able to provide activities in the evenings. On the first day of a guests stay the staff discuss with them what they would like to do and where they would like to go and this then forms the plan for their stay. Staff said that this is very flexible and we saw that this is true during our visit to the Centre. For example, one of the guests had asked to do a particular activity and had then changed their mind. The staff made several changes to their plans to ensure that the guest was supported to do what they wanted to do. Rainbow House (Holiday Centre) DS0000027335.V374264.R01.S.doc Version 5.2 Page 11 If guests are unable to look after their own money then there are suitable procedures in place for looking after it for them. This system was checked on the day of our visit and we could see that receipts, records and cash are able to be easily audited. Rainbow House (Holiday Centre) DS0000027335.V374264.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, 14, 15, 16 & 17 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Guests are supported to take part in enjoyable activities as part of their holiday. Guests enjoy their meals and are offered a choice. EVIDENCE: The staff said that the improved mix of guests and the increase in staffing has meant that they are able to provide the guests with a more enjoyable holiday. One of the guests told us that they really enjoy staying at the Centre as they are able to go out and do “fun things” as well as having things to do if they are spending time within the Centre. The Centre has a soft play room as well as a sensory room. There is a large play/activity room which has computers, television, dvd as well as games and toys. There is also a television and dvd player in the lounge. Guests are able to have televisions in their bedrooms if they want them. Rainbow House (Holiday Centre) DS0000027335.V374264.R01.S.doc Version 5.2 Page 13 The Manager said that the swimming pool is no longer in use. The surveys that we received from guests and relatives were positive about the quality of the holiday that guests receive. Additional comments were made such as: “provides an active, busy holiday” “they provide excellent breaks” “I always know that …has had a good holiday” The staff plan the guests holiday with them when they arrive. The additional staff means that guests have more choice about where they go and what they do. It also means that guests can stay at the Centre if they decide they do not want to go out. On the day of our visit the guests had gone out to three different places and one guest had chosen to remain at the Centre. The Manager said that for some guests they have 1:1 staffing to meet their needs and to ensure that they, and the other guests, have an enjoyable time. Two of the guests had additional 1:1 staffing on the day of our visit. Following an incident whilst out in the community the Manager has reviewed the procedures for supporting guests when away from the Centre. Staff told us that this has improved the safety of guests and staff when away from the Centre. The Centre is situated in the town of Sheringham and the local facilities there. It is also close to a number of Norfolks tourist attractions and the staff have a good knowledge of the range of activities available in the area. The Centre has transport, including a mini bus with wheelchair access. There has been another change in the kitchen staff since the last Inspection and the Manager said that the new cook is due to start work shortly. Currently the meals are being prepared by the two kitchen assistants with support from staff when necessary. We spoke to one of the kitchen assistants and they have a good understanding of the different dietary needs of the guests. He said that the staff provide the kitchen staff with a written record of the dietary needs and the guests preferences for each week and that the staff are always available for advice if needed. One of the guests told us that they like the meals and that they can have a choice about what they have. They said that they can have snacks and drinks whenever they like. There is fruit and drinks on the side in the dining room. Rainbow House (Holiday Centre) DS0000027335.V374264.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 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The personal and healthcare needs of the guests are met. Medication is managed safely EVIDENCE: The care plans contain detailed information about how to meet the individual needs of guests. There is a lot of information relating to how the guest likes to have their personal care provided and of any healthcare needs. The booking form asks for information about how the guest expresses when they are not very happy and how they can be supported then. This is good information for staff as some guests can be homesick when away from home, possibly for the first time. During our visit to the Centre we observed the Manager and staff making a lot of effort to support a guest who was staying at the Centre for the first time. They put a lot of time and thought into ensuring that the guest was happy with what she was doing and arrangements were changed several times to accommodate the guests needs. Rainbow House (Holiday Centre) DS0000027335.V374264.R01.S.doc Version 5.2 Page 15 The booking form includes the details for guests GP and any other healthcare professionals involved in their care so that they can be contacted in the case of emergencies. Staff said that the increased staffing in the evenings means that guests are able to go out more in the evening and also to have more choice about what time they go to bed. On the day of our visit some guests had already gone out when we arrived, others were having breakfast and one guest had chosen to have a lie in. The responses within the relatives surveys are positive about the care provided to guests during their stay at the Centre. They state that they are confident in the care provided. Since the last Inspection improvements have been made to the medication system. This has also followed several medication errors that were made in the few months between the last Inspection and July 2008. The Manager has reviewed the procedures and has also ensured that staff have received additional training. Only one medication error has been notified to us since July 2008. We looked at the medication system and could see that there have been several improvements which have made the system more safe. There is a board on the wall by the cupboard which clearly states the names of the guests and what medication they take and at what times. The Manager said that this is just a quick reference for staff but that they still use the medication administration records. Regular audits are now taking place of medication which will quickly identify if there are any problems. Staff receive training with regard to the administration of medication as well as about issues affecting individual guests. For example, staff have received training about epilepsy, diabetes, mental health as well as in the use of specific pieces of equipment. Recently the specialist nurse had provided training for staff about the use of a feed pump that one of the guests uses. Rainbow House (Holiday Centre) DS0000027335.V374264.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): 22 & 23 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Complaints are taken seriously. Procedures and staff training are in place to provide protection to the guests from abuse. EVIDENCE: The relatives surveys all indicate that they are aware of the complaints procedure. The Manager said that they have not received any complaints and there have not been any referrals to Safeguarding. The Commission has not received any complaints. Some of the guests have difficulties with verbal communication and so the information within the booking forms about how they communicate when they are not happy with something is very important for staff. The Centre provides holidays for both children and adults during separate weeks. Therefore staff receive Safeguarding training with regard to children and to vulnerable adults. Staff have recently all attended Safeguarding children training during their recent training week. Staff who spoke to us confirmed that they have received the training and said that they were confident that the Manager would deal with any concerns in an appropriate way. Rainbow House (Holiday Centre) DS0000027335.V374264.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 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. The Centre provides adequate accommodation EVIDENCE: The bedrooms and communal areas of the Centre have an ongoing redecoration and refurbishment programme and the staff try hard to ensure that any damage to the environment is addressed quickly. This can be difficult at busy times, particularly in the school holidays. Some areas of the Centre have been redecorated since the last Inspection and some new furniture has been purchased. However, some areas remain in need of redecoration and refurbishment. The organisation have plans in place for the work to be done on an ongoing basis. At the last Inspection it had been noted that the Centre was quite cold in areas but this was not the case during our visit this time. The Manager said that there are no problems with the heating. Rainbow House (Holiday Centre) DS0000027335.V374264.R01.S.doc Version 5.2 Page 18 We noted that there are toiletries in the bathrooms although the Manager said that the guests all have their own toiletries and that communal toiletries are not used. We also noted that cleaning materials were not all locked away although were on high shelves. The Home employs domestic staff and the Home was seen to be clean and free from offensive odours on the day of our visit. Rainbow House (Holiday Centre) DS0000027335.V374264.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, 33, 34 & 35 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The staffing levels meet the needs of the guests. Staff receive appropriate training and supervision to carry out their roles effectively. EVIDENCE: Staff confirmed the Managers view that the increased staffing has meant improvements to the quality of the holiday that guests receive. There are now usually five staff on duty from 7.30am to 4.30pm and five staff on duty from 1.30 to 10pm. Two waking night staff work from 8pm to 8am. This means that there are additional staff on duty during the day but that there is also a long handover period during the early afternoon and in the early evening which enables even more activities to be offered to guests. In addition to this some guests have a 1:1 member of staff to provide support to them during the day. The Manager said that they have recruited permanent staff and bank staff since the last Inspection. She said that agency staff are only used to provide Rainbow House (Holiday Centre) DS0000027335.V374264.R01.S.doc Version 5.2 Page 20 some of the 1:1 staffing support and that bank staff usually work the shifts that can not be covered by permanent staff. The staff who spoke to us were enthusiastic about working at the Centre and said that there have been improvements since the Manager started work there in December 2007. Staff are clear that they aim to provide an enjoyable holiday for guests whilst meeting their personal and healthcare needs. We looked at a selection of staff recruitment files and could see that the necessary checks had been carried out prior to staff starting work at the Home. The Manager confirmed that the induction for staff conforms to the Common Induction Standards. She said that there is a training week in January when the Centre is closed and all staff receive updates of mandatory training. Staff then attend other training sessions throughout the year. The organisation has a training manual for staff to choose from and the Manager agrees training needs during supervision sessions. Additional training has been provided in subjects such as Professional Boundaries, use of feed pumps, administration of Buccal Diazolam, Mental Capacity Act, autism, supervision. The staff said that they feel well supervised and that the Manager and deputy manager are approachable and they feel that they can talk to them about issues. Regular staff meetings take place and staff said that the recent training week provided good team building opportunities also. The surveys from relatives and guests indicated that they feel that the guests needs are met by the care staff at the Centre. Additional comments were made such as: “what would we do without such wonderful, caring and helpful staff” “cannot fault them” “they are friendly, caring and professional” Rainbow House (Holiday Centre) DS0000027335.V374264.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, 38, 39 & 42 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The Centre is well managed, in a way which puts the needs of the guests first. The views of the guests and relatives are sought on a regular basis. Health and safety is given a high priority. EVIDENCE: At the time of the last Inspection (Jan 08) the Manager, Christine Eves, had recently started work at the Home and was the acting manager. She was appointed as the Manager soon after and has completed the registration process with the Commission. Ms Eves has a lot of experience of managing a care home and of working with children and young people. She has worked hard to attend training and to learn from others about the areas in which she had not had much experience. Rainbow House (Holiday Centre) DS0000027335.V374264.R01.S.doc Version 5.2 Page 22 The staff said that the Manager is enthusiastic and has worked hard to ensure that there is good team work and that the needs of the guests are being met. The Manager has dealt with some difficult staff situations and provides good support to staff. The Centre also has a deputy manager and a team of Senior care staff. There is always a senior staff on duty and there is an on call system for out of hours support if needed. The Manager has implemented new ways of working which encourage staff to be more focused on the needs of individual guests. The senior staff on duty completes a shift plan which acts as a guide to what responsibilities each member of staff will have during the shift. The Operations Manager provides regular support and supervision to the Manager and visits the Centre. The guests are always provided with a questionnaire about their stay and the bookings co-ordinator has previously compiled the responses into a report. She said that she intends to do this on an annual basis. The Manager had completed the Annual Quality Assurance Assessment and returned this to us which also acts as a way of reviewing the quality of the service provided. The organisation has a member of staff responsible for Health and Safety issues and the Manager said that she liases with him about any concerns to do with health and safety. We looked at a selection of health and safety records and can see that regular maintenance and servicing of equipment takes place, including the fire safety equipment. Regular fire drills take place. Rainbow House (Holiday Centre) DS0000027335.V374264.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 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 3 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 3 3 X X 3 X Rainbow House (Holiday Centre) DS0000027335.V374264.R01.S.doc Version 5.2 Page 24 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 YA24 Refer to Standard Good Practice Recommendations It is recommended that toiletries and cleaning products are kept more securely Rainbow House (Holiday Centre) DS0000027335.V374264.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 Rainbow House (Holiday Centre) DS0000027335.V374264.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. 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