Care Home: Respond

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What the care home does well The home is clean, comfortable and attractive and offers residents a comfortable place to stay. The large gardens are well kept and are used by residents during nice weather. All of the rooms are light and airy and are pleasantly decorated and furnished. The home is well managed to benefit the residents. Residents and carers say that staff are caring and kind and that the managers are approachable. The staff are well trained and highly skilled. The admission process is clear and residents and carers are provided with sufficient information to know if the home can meet their needs. Written records are good and help staff to know what care residents need. The home has an easy to access complaints policy and residents feel they are listened to and can have a say in how the home is run. The home is very good at making sure residents can say what they like to do and they are always given a choice. What has improved since the last inspection? Since the last inspection the recruitment files for staff have been kept in the home so that they can be examined during inspection. Residents are being asked what they think of the service and how it might improve. The senior managers have been undertaking regular visits to the home to check that the home is running well to benefit residents. The home has drawn up an annual development plan outlining how the home will develop in the forthcoming year. The fire risk assessment has been up-dated to ensure that it reflects the needs of people that use the service. CARE HOME ADULTS 18-65 Respond 3 Priors Close St Laurence Way Slough Berkshire SL1 2BQ Lead Inspector Julie Willis Unannounced Inspection 26th June 2008 09:45 Respond DS0000031734.V365472.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 Respond DS0000031734.V365472.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. Respond DS0000031734.V365472.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Respond Address 3 Priors Close St Laurence Way Slough Berkshire SL1 2BQ 01753 554435 01753 570866 paul.nicoll@slough.gov.uk 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) Slough Borough Council Mr Paul Raymond Nicoll Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Respond DS0000031734.V365472.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th March 2007 Brief Description of the Service: Respond provides planned and emergency respite care for service users with a learning disability and their carers from mainly the Slough area. Service users aged between 18 and 65 with learning and associated physical disabilities are offered a pattern of respite care based upon an assessment of individual need. The service provides a specialist resource for those people with challenging behaviour and is increasingly being asked to provide a service to individuals with additional complex health needs. All accommodation is within single bedrooms, which are set up to meet the needs of each individual before their arrival. The service has a range of specialist aids and equipment to meet the needs of service users, including hoists, sensory equipment and adapted bathing facilities. The unit cost of this service is £25,244 per bed per annum The charges to users of the service (living in Slough) who are 18 - 25 years are currently £4.40 per night. Users aged 25 – 65 (living in Slough) is £6.40 per night. The cost to other Local Authorities is £124.57 per night Respond DS0000031734.V365472.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 3 star. This means that people who use this service experience excellent quality outcomes. This unannounced inspection took place on weekday morning and afternoon over the course of five hours. It was a thorough look at how well the service is doing. It took into account detailed information provided by the service’s manager, and any information that CSCI has received about the service since the last inspection. Prior to the visit an AQAA (Annual Quality Assurance Assessment) questionnaire was sent to the Manager, which provided the inspector with information about the service. Consideration has also been given to other information that has been provided to the Commission since the last inspection. The inspector toured the building, examined records and met all of the residents. The inspector also spent time talking informally to staff and observing how care was being delivered to the residents. From the evidence seen by the inspector and comments received, the inspector considers that this service has a good awareness and understanding of equality and diversity issues and would be able to provide positive outcomes for residents in the areas of race, ethnicity, age, gender, sexuality, disability and belief. The inspector gave feedback about her findings to the homes Manager at the end of inspection. There were no legal requirements made as a result of this inspection. The Commission has received no information concerning complaints since the last inspection. What the service does well: The home is clean, comfortable and attractive and offers residents a comfortable place to stay. The large gardens are well kept and are used by residents during nice weather. All of the rooms are light and airy and are pleasantly decorated and furnished. The home is well managed to benefit the residents. Residents and carers say that staff are caring and kind and that the managers are approachable. The staff are well trained and highly skilled. Respond DS0000031734.V365472.R01.S.doc Version 5.2 Page 6 The admission process is clear and residents and carers are provided with sufficient information to know if the home can meet their needs. Written records are good and help staff to know what care residents need. The home has an easy to access complaints policy and residents feel they are listened to and can have a say in how the home is run. The home is very good at making sure residents can say what they like to do and they are always given a choice. 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. Respond DS0000031734.V365472.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 Respond DS0000031734.V365472.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): Standard 2 People who use the service experience excellent quality outcomes in this area. People are fully assessed prior to admission to ensure staff have sufficient information to provide the right care. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Respond provides a person-centred service to people living in the community that require regular respite care. People aged between 18 and 65 with learning and associated physical disabilities are offered a pattern of respite care based upon an assessment of individual need. The home caters for people with challenging behaviours and can also meet the needs of people with complex health needs. From examination of training records it is clear that staff are provided with the specific training they need to meet those needs. The home has an admissions policy in place, which details the comprehensive and holistic assessment that will take place prior to admission. It recognises the need to fully involve the person to be admitted, their families, advocates and a multi-disciplinary team of professionals. Senior staff from the home carry out a full needs assessment in the persons home. The information is collated on a laptop computer which is also used to show prospective users of the service how the home functions and what it has to offer. The information Respond DS0000031734.V365472.R01.S.doc Version 5.2 Page 9 has been produced in a user-friendly format and shows a video recording that has been put together with the help of past and current users of the service. There was evidence that considerable effort is made to ensure that each persons respite is fully planned. This includes ensuring that there are sufficient levels of staff on duty to enable the home to offer one-to-one or two-to-one support. Additionally, the home takes into consideration the needs and relationships between its individual users reducing occupancy levels when needed to accommodate people with specific needs and behaviours. The service is efficient in obtaining up-to-date information about each person using the service. It insists on receiving a copy of the Care Management needs assessment and care plan at the time of referral. Up-to-date information is gathered from carers or advocates before each subsequent admission. One carer said, “I don’t know what I would do without Respond, it gives me a break when I need it”, “the staff are excellent, I trust them”. The carer also said, “I know she enjoys staying, its like a holiday for her, I can go away without worrying”. When asked about the admission process the carer said, “to be honest I knew nothing of the service, but my mind was put at rest when I visited for the first time”, “people were so kind here and they really knew and understood the people they were caring for”. Respond DS0000031734.V365472.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): Standards 6, 7, 9 People who use the service experience excellent outcomes in this area. The care plans were sufficiently detailed to enable staff to effectively meet people’s need and activities that could be hazardous were underpinned by effective risk assessment and risk management strategies. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The AQAA states that the primary focus of the service is to positively promote service users “feelings, needs, aspirations and welfare”. The care plans are developed with and owned by the person using the service. They are based on a full and up-to-date holistic assessment, which addresses the equality and diversity needs of the individual including gender issues, age, race, religion, disability and where known sexual orientation. The inspector case tracked 4 peoples care from their initial referral (where available) to date. It was clear that the staff have tried to involve people that use the service in the care plan process from the outset and their input was Respond DS0000031734.V365472.R01.S.doc Version 5.2 Page 11 clearly recorded in the care files. Some areas of the plans had been developed in a pictorial format to help residents to understand the content. Plain English and simple terms are used whenever possible. The care records were comprehensive and holistic in detail and provided sufficient information for staff to provide the appropriate care. A specific statement of need is now incorporated into the plan, which focuses on the users perspective. For those people who are not able to communicate verbally the link-worker interprets their needs and aspirations with a ‘person-centred planning statement’. A likes and dislikes statement is also attached to all care plans which identifies how users wish to be cared for. The document serves as a reminder to staff on what the individual wants from their stay. It was evident that the home encourages people to develop their independence and life skills. This has led to a degree of risk taking for some of the people using the service. Management of risks takes account of the specialist needs of the individual balanced against people’s personal aspirations for independence, choice and normal living. The content of care plans evidenced that people are supported to take risks as part of their everyday life style and to experience new situations and to try new things. Risks have been fully assessed and guidelines have been put in place to minimise the risk to people using the service. Respond DS0000031734.V365472.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): Standards 12, 13, 15, 16, 17 People who use the service experience good outcomes in this area. People that use the service take part in activities that provide opportunity for personal, practical and emotional development and are encouraged to be part of the local community. People are provided with a menu that is nourishing, varied and meets their individual and cultural need. This judgement has been made using available evidence including a visit to this service. EVIDENCE: It was evident from discussion with staff, management, residents and carers that the service is committed to maintaining peoples contact with the community whilst people stay at Respond. Residents are encouraged to continue their activities as normal, in order to make their transition from home to respite as seamless and relaxed as possible. This includes continuing their attendance at day services, education or within a paid work role. At the time of inspection one user of the service was continuing their gardening job whilst another was at college. Both valued their attendance at these activities. Respond DS0000031734.V365472.R01.S.doc Version 5.2 Page 13 Additionally, people that use the service are provided with the opportunity to make use of communal facilities including local restaurants, cinemas, sports facilities and public houses. People’s attendance at each activity is well documented and their overall progress is monitored as part of their yearly review. At home residents listen to music, watch television, or are supported to go for walks to the local park or shopping centre. At the weekends trips out may be arranged to meet the specific needs and interests of residents. Recent trips have included a visit to Madam Tussauds and a trip to the ‘Horse of the year show’. There was evidence on file that each Sunday a residents meeting is arranged which aims to consult residents about all aspects of life at the home. A regular topic is the choice of menu for the forthcoming week. Residents requiring special diets can be catered for. Those residents requiring support during mealtimes are assisted in a discrete and sensitive manner. The home aims to make mealtimes a relaxing and pleasurable experience and a time when residents can get together and socialise. One resident commented that the food was “good”. Respond DS0000031734.V365472.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): Standard 18, 19, 20 People that use the service experience excellent quality outcomes in this area. Peoples physical and personal support needs are well met at this home and well-trained and competent staff deal with medication safely and appropriately. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Effective systems are in place to ensure the personal and healthcare needs of residents are met effectively at the home. From examination of four of the person-centred care plans it is clear that that the content fosters independence and promotes resident choice and autonomy. Residents confirmed that they have the opportunity to say how they wish to be cared for and can decide which staff members they want to help them with personal care tasks such as toileting, bathing and showering. The staff group is balanced to enable choice of male, female and age related preferences. The staff team are widely experienced and highly skilled and have access to appropriate training in health related matters. All staff undertake core skills refresher training at regular intervals and additionally are provided with Respond DS0000031734.V365472.R01.S.doc Version 5.2 Page 15 specialist training to support them to meet the needs of people using the service. All staff are required to undertake Studio 3 training, which equips them with a range of distraction techniques in order to diffuse challenging situations. In addition staff have received training in epilepsy, diabetes and dementia care to assist them in their work role. From examination of documentation it is evident that the home is reliant on good communication systems and effective partnership working. In one file it gave clear instructions to staff on what to do if there was a breakdown in the placement which involved working closely with the EDT (Social Services emergency duty team) The home has clear behavioural guidelines in place when individual residents are involved in violent, abusive or destructive outbursts. Many of the current people using the service require higher levels of staffing including one-to-one or two-to-one staffing levels. The home often reduces the number of residents accommodated when catering for the needs of specific individuals with very challenging behaviours. The care plans are detailed and holistic and consider all aspects of a person’s lifestyle including their health and social care needs. Care plans are regularly reviewed and updated and any changes to the plan are discussed and agreed with the resident and their family. All risks to residents are fully assessed and effective guidelines and equipment is in place to reduce the likelihood of occurrence. All care given is documented in the daily records and examination of the content fully validated the care plans. Observation of practice demonstrated that care was provided in a manner, which maintained the residents right to dignity, privacy, independence and choice. At the end of each persons respite stay a report is forwarded to the residents Care Manager in Social Services that gives an account of the stay. This helps to encourage excellent two-way communication between the purchaser and provider of services and assists in future planning of care. The home has robust medication policy, procedure and practice guidance in place. Medication is correctly checked in by two of the staff at the time of the resident’s admission. It is stored securely in a locked medicine cupboard and administered by two people to ensure that the administration system is safe. All staff are fully trained and have undertaken a formal assessment before they may administer medication at the home. Respond DS0000031734.V365472.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): Standard 22 & 23 People that use the service experience excellent quality outcomes in this area. People who use the service are able to express their concerns and have access to a robust, effective complaints procedure. They have their rights protected and are protected from abuse and exploitation. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home works closely with the CTPLD (Community Team for People with Learning Disabilities) to ensure the safety and welfare of vulnerable adults. Respond is Slough Social Services crisis/emergency resource, which provides immediate protection and a place of safety for adults with a learning disability who may be in need or immediate danger. Therefore staff are highly trained in crisis management, counselling skills and safeguarding procedures. The home has a proven track record of positive and timely interventions to protect people from harm. It is a highly regarded resource and considered invaluable to the carers and service users it supports. One carer said “I couldn’t do without them”, “the staff are brilliant, I only need to phone and they go the extra mile to help me”. “There should be more of this type of service around”. The home pro-actively responds to complaints and is open and transparent in the way it deals with them. It uses complaints as part of its quality assurance systems to monitor its own performance and help to identify where it can improve the quality of service to its users. Respond DS0000031734.V365472.R01.S.doc Version 5.2 Page 17 The complaint policy in the home meets the requirement of Standard and Regulation. Residents and relatives are provided with information on how to make a complaint to the home and the formal stages in procedures. The complaints procedure is in a user-friendly format and is available in a number of languages to aid accessibility and understanding. Examination of the complaint records indicated that there have been 2 complaints made to the home since 1st January 2008. The details of the complaints were well documented and indicated that an investigation had taken place and an outcome had been provided to the complainant. There has been no information about complaints reported to the CSCI about the home since the last inspection. There was evidence in staff files and from discussion with staff, that they receive training in ‘Safeguarding Adults’ as part of their formal induction to the home which is later consolidated when undertaking NVQ training in which it forms a core module. Staff are fully trained in Studio 3 distraction techniques to help them to de-escalate episodes of challenging behaviours and to work with users in a pre-planned and uniform way. Observation of care practice concluded that staff were patient and understanding when dealing with residents and appeared mindful of the need to respect their privacy at all times. Staff interviewed were aware of the homes whistle-blowing policy and understood the importance of protecting residents from abuse and exploitation at all times. The residents confirmed that they felt safe and well cared for. Respond DS0000031734.V365472.R01.S.doc Version 5.2 Page 18 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): Standard 24 & 30 People using this service experience good quality outcomes. The physical design and layout of the home enables residents to live in a safe, wellmaintained and comfortable environment This judgement has been made using available evidence including a visit to this service. EVIDENCE: From a tour of the building it is clear that the home is well maintained for the benefit of residents. All communal areas were clean, airy and well lit and were decorated and furnished to a comfortable standard. The home has a rolling programme of routine maintenance and renewal and a budget is available that reflects this. In the past year the majority of bedrooms have been redecorated and new furniture including tables, chairs and blinds have been purchased for the communal areas. Since the last inspection a volunteer has maintained the gardens to a high standard. The volunteer is an ex-user of the service and has chosen to say thank-you for the support they were given by doing voluntary work in the Respond DS0000031734.V365472.R01.S.doc Version 5.2 Page 19 gardens. This enables the home to monitor the volunteer’s welfare on behalf of CTPLD and offers a safe environment in which the person can work whilst they benefit from the company of others. At the time of inspection the gardens were welcoming and well kept. The home has a range of aids and equipment available to maintain residents independence and to promote safe care. Profiling beds are available for residents that need them and specialist mattresses are used routinely to promote tissue viability for residents with complex health care needs. There is a choice of bathing and showering facilities both assisted and unassisted and there are sufficient toilets placed strategically around the home to meet the needs of residents. All bathrooms, toilets and sluices have a supply of liquid soap and hand towels to maintain satisfactory infection control standards. The home was clean and hygienic throughout there were no residual odours noted. One carer confirmed that the home is always clean and well maintained and staff work hard to provide a pleasant environment for the residents. Discussion with staff and examination of the staff training records evidenced that all staff have received refresher training in infection control and health & safety. Respond DS0000031734.V365472.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 32, 34, 35 People who use the service experience excellent outcomes in this area. There were sufficient numbers of staff on duty at the time of inspection to meet the needs of residents effectively. The skill mix of the staff team was appropriate for the size, layout and purpose of the home. Recruitment policies and procedures at the home are robust and transparent and ensure the safety of residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a well-developed and robust recruitment process that has the people who use the service at its core. The recruitment of appropriately trained and skilled carers is considered key to providing a high quality service. To aid the recruitment process a panel of service users undertake part of the interview process meeting and questioning all candidates. They then give their opinions to management as to who would be most suitable. The staff team reflect the local community and are from a diverse range of backgrounds, cultures and experiences. The home aims to match the needs of its users with that of its staff and therefore recruitment of people with diverse Respond DS0000031734.V365472.R01.S.doc Version 5.2 Page 21 backgrounds is considered most helpful. All staff have been provided with equality and diversity training to help them meet the needs of people who use the service. Examination of four staff records and discussion with staff and management indicated that all necessary checks are undertaken on prospective staff to ensure the safety and protection of residents. Records were well kept and met the required standard. Examination of the staff files and training records evidenced that all of the current staff have gained an NVQ qualification at level 3 or 4. The Registered Manager is a qualified Social Worker and Practice Teacher and the deputy has an NVQ 4 and Certificate in Management. Several of the staff hold professional qualifications in social care. All staff are highly motivated and are keen to further enhance their skills and knowledge. The staff records were well kept and contained copies of induction training, job descriptions, application forms, two written references, training certificates, supervision and appraisal records. These were examined to evidence compliance with good practice. All staff have been police checked to ensure they are suitable to work with vulnerable adults. The home has an up-to-date training record, which provides the dates of all training that has been undertaken by staff. The Homes Deputy Manager undertakes regular audits of the training records and identifies future training needs and requirements linked to fulfilling the business and financial plan for the home. The following comments were made to the inspector about the qualities of the staff. One resident said, “the staff are good” and a carer commented, “the staff are brilliant, they always listen to me and I trust them completely”, “you really couldn’t get any better”. Respond DS0000031734.V365472.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37, 39, 42 People who use the service experience good outcomes in this area. The resident’s benefit from living in a well managed home, where there is evidence that there health, welfare and safety is of primary importance. The registered person is qualified, competent and experienced to run the home for the benefit of residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager in charge of the home Paul Nicoll is well qualified, highly experienced and is an effective and well-respected leader. He is supported in his task by an able and highly skilled staff team. Staff confirm that the Homes Manager demonstrates effective leadership skills and is accessible and supportive. Staff confirm that they have the opportunity to express their Respond DS0000031734.V365472.R01.S.doc Version 5.2 Page 23 opinions openly in staff meetings, supervision sessions and staff handovers. They say that they are provided with plenty of opportunity to express concerns, share information and to feel included and involved in the way the service is delivered. The home is constantly monitoring its performance against its stated aims and objectives. Each year it carries out a quality assurance survey of its customers and stakeholders. The results are very positive and demonstrate that this is a highly valued resource. A sample of health and safety records were examined including fire records, gas safety records, PAT tests and water temperatures. These checks evidenced that essential servicing and maintenance of equipment is undertaken routinely to safeguard the health and welfare of users. Servicing and safety certificates were available on file. Unnecessary risks to users are identified using comprehensive risk assessments that are reviewed at regular intervals. So far as possible risks are reduced or eliminated. Respond DS0000031734.V365472.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 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 4 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 4 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 4 33 x 34 3 35 x 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 3 x 3 x 3 x x 3 x Respond DS0000031734.V365472.R01.S.doc Version 5.2 Page 25 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. 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. Refer to Standard Good Practice Recommendations Respond DS0000031734.V365472.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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. 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