Care Home: Smug Oak House

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What the care home does well The staff team have worked extremely hard to improve the quality of life of the people living at Smug Oak House since the last inspection was carried out. The staff continue to adjust well to the major changes within the staff team and have worked hard to ensure that the service provided to the people living at Smug Oak House is consistent and professional. The people using the service have both complex needs, including challenging behaviour which require the manager and staff team to be both professional and consistent in their approach with the people using this service. Staff were observed to be calm, relaxed and caring when offering care and support to people. The environment continues to be improved and further developed and now provides a homely domestic setting in which the service users can live safely and lead lifestyles that suit them. However due to the complex needs of the people living within Smug Oak House the environment is in constant need of updating, repair and improvement. In particular, the bedrooms are decorated and furnished to reflect the taste of the individual. The communal areas of the home were domestic and were clean on the day of the inspection. The care planning system within this service is excellent and provides a comprehensive and detailed insight into the needs each individual living within this service. The staff training programme continues to offer a diverse and interesting choice of courses that the whole stay team have the opportunity to attend. Communication systems within the service have also greatly improved and now offer wider opportunities for people to communicate their needs more effectively. These include pictorial menu`s and communication boards withinpeople`s bedrooms. The manager of the service has produced an excellent pictorial Service User Guide. What has improved since the last inspection? The environment has improved since the last inspection, which has included a complete replacement of the central heating and hot water system, which had caused continual problems in the past with fluctuating hot water temperatures. The support plans have been greatly improved and now provide a true reflection of people`s needs. The manager and staff provide a consistent and professional approach to everyone using the service, which at times, can present as both challenging and stressful. In particular during recent months where there has been a rise in challenging behaviour incidents involving one particular user of the service. The new manager has implemented some very effective systems into the service, in particular, record keeping, updating and reviewing of care plans and risk assessment. Medication systems have also been radically developed and improved by one senior support worker. Quality assurance systems are now effective in monitoring all aspects of the service. The manager has also reviewed the daycare provision within the service, which now provides a more realistic and varied daytime activity programme. This includes at least one day a week off from the daycentre to spend taking part in social and leisure activities. What the care home could do better: There is very little that the current service requires improving. The environment can always benefit from being further developed. The current location of the service can be restrictive in relation to encouraging and supporting people`s independence as it is located some distance from the local shops, pubs and leisure activities. The placement of one particular service user requires constant reviewing due to their severe challenging behaviour needs and this caused some concern for the inspector in relation to the vulnerability of some of the other people living within this service. The manager agreed to keep us informed of any further and future developments. The manager and staff should continue to improve the communication systems within the service to incorporate pictorial aids wherever possible. CARE HOME ADULTS 18-65 Smug Oak House Drop Lane Bricket Wood St Albans Hertfordshire AL2 3TX Lead Inspector Julia Bradshaw Unannounced Inspection 19th August 2008 14:00 Smug Oak House DS0000019528.V370313.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 Smug Oak House DS0000019528.V370313.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. Smug Oak House DS0000019528.V370313.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Smug Oak House Address Drop Lane Bricket Wood St Albans Hertfordshire AL2 3TX 01923 857 223 01923 854 823 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.pentahact.org.uk PentaHact Limited trading as Adepta Christine Balanchandre Care Home 10 Category(ies) of Learning disability (10) registration, with number of places Smug Oak House DS0000019528.V370313.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14th March 2008 Brief Description of the Service: Smug Oak House offers a purpose built residential service for 10 adults with Autistic Spectrum Disorders and other associated needs. The house has been divided into three units, one for 5 residents, one for 4 and one for 1. This was done to help staff accommodate the differing needs of the residents. Everyone at Smug oak houses attends the nearby day centre that is also run by Adepta and is a specialist centre for people with Autism. The house is in a very rural setting some distance from most amenities, but the house has its own transport and service users access the local community frequently. The slightly isolated setting of the home does in some ways suit the particular needs of the service users. The service offered is specialised and individually tailored to meet the very complex needs of the residents all but one of whom have lived there since it opened, in fact the service was set up and designed specifically for them. Information regarding the service is available within the Service Users Guide and Statement of Purpose. The current fees for Smug Oak House are from £1453 and £1,834. For more details and a copy of the most recent CSCI inspection report please contact the manager. Smug Oak House DS0000019528.V370313.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 stars. This means the people who use this service experience excellent quality outcomes. The information in this report is based on an unannounced visit to the home by one regulation inspector carrying out the work of the Commission. The inspection covered a variety of aspects of this service including, talking to staff members, people who use the service, a tour of the building, staff recruitment records, three care plans were case tracked, and health and safety records, staff training and management systems within the service were also inspected. What the service does well: The staff team have worked extremely hard to improve the quality of life of the people living at Smug Oak House since the last inspection was carried out. The staff continue to adjust well to the major changes within the staff team and have worked hard to ensure that the service provided to the people living at Smug Oak House is consistent and professional. The people using the service have both complex needs, including challenging behaviour which require the manager and staff team to be both professional and consistent in their approach with the people using this service. Staff were observed to be calm, relaxed and caring when offering care and support to people. The environment continues to be improved and further developed and now provides a homely domestic setting in which the service users can live safely and lead lifestyles that suit them. However due to the complex needs of the people living within Smug Oak House the environment is in constant need of updating, repair and improvement. In particular, the bedrooms are decorated and furnished to reflect the taste of the individual. The communal areas of the home were domestic and were clean on the day of the inspection. The care planning system within this service is excellent and provides a comprehensive and detailed insight into the needs each individual living within this service. The staff training programme continues to offer a diverse and interesting choice of courses that the whole stay team have the opportunity to attend. Communication systems within the service have also greatly improved and now offer wider opportunities for people to communicate their needs more effectively. These include pictorial menu’s and communication boards within Smug Oak House DS0000019528.V370313.R01.S.doc Version 5.2 Page 6 people’s bedrooms. The manager of the service has produced an excellent pictorial Service User Guide. What has improved since the last inspection? What they could do better: There is very little that the current service requires improving. The environment can always benefit from being further developed. The current location of the service can be restrictive in relation to encouraging and supporting people’s independence as it is located some distance from the local shops, pubs and leisure activities. The placement of one particular service user requires constant reviewing due to their severe challenging behaviour needs and this caused some concern for the inspector in relation to the vulnerability of some of the other people living within this service. The manager agreed to keep us informed of any further and future developments. The manager and staff should continue to improve the communication systems within the service to incorporate pictorial aids wherever possible. Smug Oak House DS0000019528.V370313.R01.S.doc Version 5.2 Page 7 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. Smug Oak House DS0000019528.V370313.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 Smug Oak House DS0000019528.V370313.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): 1, 2, 3 and 4. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People using the service can be assured that the information about the service is kept up to date and provided for all prospective users of this service and that everyone wishing to enter the home has a full assessment of need completed. This ensures that all parties can be sure the service can meet all individual needs. The terms and conditions of the service are agreed in writing so that people are clear about the roles and responsibilities of all those within the service. EVIDENCE: A detailed pictorial Statement of Purpose and Service User Guide is in place. These are kept up to date and are available to prospective users of this service. The manager has recently supplied the Commission with an updated version which should be held as an excellent example of how service user information should be produced A total of three care plans were reviewed and evidence gained regarding the initial assessments that are carried out to access if the service can meet the needs of the person. Information is held regarding the person’s history and current needs. An assessment of each person’s needs and aspiration are made before the person moves into the service. Competent and qualified staff Smug Oak House DS0000019528.V370313.R01.S.doc Version 5.2 Page 10 complete the assessments. The service also receives and seeks external specialist support to meet the individual’s needs. Whole life reviews occur to support the service users in achieving and reviewing individual needs, goals and aspirations. The assessment process includes the gathering of information from other professionals. Smug Oak House has its own internal assessment forms, which have been further developed since the last inspection was carried out. A contract is drawn between the service provider and the person using the service. The contract includes the terms and conditions within the service and the rights of the people who live at Smug oak house. Smug Oak House DS0000019528.V370313.R01.S.doc Version 5.2 Page 11 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, and 9. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People who use the service can be very confident that the care plans reflect a detailed and comprehensive record of people’s needs, which ensures that people using the service are assessed, reviewed and safe from risk. EVIDENCE: Three care plans were inspected in detail and were found to provide a detailed and comprehensive insight into each individual’s needs. Individual notes and guidelines for people were observed within the service. The manager and staff have worked particularly hard to produce these care plans in a pictorial format that can be easily understood by each person living within the service. Everyone living at Smug Oak House is supported within the whole life review framework and reviews occur to ensure changing needs are continuously assessed and reviewed. Ranges of risk assessments are completed within the service and actions points recorded. These risk assessments are very detailed and contain all the required information. Activities and outings enjoyed by Smug Oak House DS0000019528.V370313.R01.S.doc Version 5.2 Page 12 people living at Smug Oak House determine that people are supported to take risks as part of an independent life style. Risk assessments have been reviewed and updated since the last inspection was carried out. Staff work with people to assist them to lead safe and enjoyable lives and regarding decision making and offering support where needed. People appeared to have been involved in the development of their support plans and consulted in the way that care is received in terms of preserving rights and dignity. The service also receives support and advice from the local community learning disabilities team based in St Albans and also uses the professional behavioural support provided by their own company. Smug Oak House DS0000019528.V370313.R01.S.doc Version 5.2 Page 13 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 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service can feel assured that they will be offered and receive appropriate opportunities for social, leisure and community involvement, which meets their needs and expectations. EVIDENCE: Detailed activity programmes are in place and presented in an individual pictorial activity planner. Activities are selected to meet people’s interests and where appropriate to enable them to achieve realistic personal development goals. The individual care plans demonstrated how people are supported to enjoy appropriate community resources. The majority of people maintain close ties with their relatives and friends and make visits/stays on a regular basis. There has been some excellent work carried out recently by a senior support worker, with a family member of one person living at Smug Oak House, which has required a considerable amount of commitment, hard work and Smug Oak House DS0000019528.V370313.R01.S.doc Version 5.2 Page 14 perseverance to support this person in resuming links with the family. The people living at Smug Oak House have enjoy a variety of trips out as part of everyone’s weekly activity programme. Everyone also has at least one day off per week to enjoy some individual social and leisure activities, which usually includes a trip out for lunch. However some people find difficulty with going into areas which are busy and crowded and therefore a risk assessment is completed on the appropriateness of some of these activities. A variety of holidays have taken place since the last inspection, which include a stay in the New forest, a holiday to Yarmouth and a trip to a holiday camp Waveney. Routines within the service are designed to promote and maintain people’s independence skills. However some of the people living at Smug Oak House have limited independence skills and therefore staff provide aditional support as required. People living at Smug Oak House are less restricted in their movement around the home, since the new manager has been in post and the people now live in less ‘institutionalised’ service, with an improvement in being able to access more areas of the home and the reduction in the amount of locked doors. Menus are offered on a flexible basis, with people making informed choices over their meals. Meals observed were unrushed and relaxed. Adequate food stocks were noted in the kitchen cupboards and freezer. Particular food preferences and dietary needs are noted in the care plans. Smug Oak House DS0000019528.V370313.R01.S.doc Version 5.2 Page 15 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 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service can be assured that their health and personal care needs are carried out effectively and respectfully, ensuring that their wishes and choices are promoted. EVIDENCE: All care provided is individual and tailored to each person needs with each persons choices and preferences being promoted. Assessments are completed ensuring that the approach adopted is person centred and holistic to each individual. People are supported with all aspects of their physical and emotional health and receive adequate and appropriate input from specialists such as community nurses, consultants, GP, dentists, opticians and dieticians. Information and advice is provided to everyone living at Smug Oak House regarding general health issues. A robust policy and procedure is in place to support the safe administration, storage and receipt of medication in and out of the service. Smug Oak House DS0000019528.V370313.R01.S.doc Version 5.2 Page 16 Medication training was evidenced from the training records for all staff who administer medication within this service. Staff spoken to on the day of this inspection confirmed that they had been both inducted and trained in the administration and safe keeping of medication. The member of staff responsible for medication should be congratulated on the standard of quality monitoring and supervision of all medication procedures within the service. Smug Oak House DS0000019528.V370313.R01.S.doc Version 5.2 Page 17 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 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in this service can be assured that they will be protected from abuse and that they will be listened to if they raise any concerns or make a complaint about any aspect of their care. EVIDENCE: The service has a detailed complaints procedure in place. A record is maintained within the service of any complaints made detailing actions and outcomes as necessary. People using the service have been informed about the complaints procedure. The AQAA stated that have been four complaints received since the last inspection was carried out and all have been resolved to a reasonable conclusion for all the parties involved. A detailed procedure is in place to ensure that people using the service are protected from abuse and harm. Staff receive suitable and adequate safeguarding training. Staff employed within the home are all subject to enhanced Criminal Records Bureau disclosure. Smug Oak House DS0000019528.V370313.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): 24 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service provides a well-maintained and safe environment for people living within the service. EVIDENCE: The environment continues to be further developed and improved with various areas of the service being re-decorated since the last inspection. These include a new central heating and hot water system being installed in April 2008. People are encouraged to bring personal items such as furniture and pictures into their room when they move in. We saw that the home was clean and odour free on the day of the inspection. The cleaning is carried out by the care staff and with service users assisting where possible. The manager and care staff monitors this to ensure that standards of cleanliness are maintained. The kitchen and laundry rooms are domestic in style and appear to manage their current workload effectively. There was adequate hand washing facilities within the service. However due to Smug Oak House DS0000019528.V370313.R01.S.doc Version 5.2 Page 19 the complex needs of some of the people using this service, occasionally there are restrictions on accessing toilet rolls and hand towels due to these being misused and blocking the toilets. The inspector felt confident that these restrictions were kept to a minimum and only used where absolutely necessary. Sufficient lighting, heating and ventilation is provided. Each person has a single bedroom. The communal areas of the home are decorated and furnished to an acceptable standard and there is a selection of home entertainment equipment for service user to access. The water temperatures on the day of the inspection were recorded within safe limits. Smug Oak House has a large rear garden which is due to be further developed with the refurbishment of the summerhouse, funded by the parents association. The staff have encourage people to create a small vegetable patch within the back garden. There are a few larger pieces of equipment in the garden, including a large outdoor swing. The manager and staff work tirelessly in maintaining the environment to an acceptable standard and on occasions the main buildings can appear a bit shabby due to the challenging behaviour needs of the people living within the service. This is not a reflection on the lack of maintenance standards of the service but a realistic view of the inspector, given the needs of the people living at Smug Oak House. Staff have worked hard to encourage people to maintain their rooms to look homely and comfortable. Some people find having curtains or any form of blinds up at the windows difficult to cope with and staff are continually looking at ways to support people with this difficulty. Smug Oak House DS0000019528.V370313.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): 32, 34 and 35. Quality in this outcome area is good.This judgement has been made using available evidence including a visit to this service. People who use the service can be confident that a loyal, experienced and welltrained staff team, who have been robustly recruited to ensure their continued safety, will support them. EVIDENCE: The new manager has worked extremely hard since the last inspection to place to improve and develop the standards for the people living at Smug Oak House. Recording systems have greatly improved, new support plans have been implemented, staff training is varied and staff are now able to access a range of both diverse and mandatory training. During this inspection there were several examples observed where staff clearly demonstrated their commitment to their work in caring for the people who use the service. Two members of staff spoken to during this inspection stated that “they found the manager approachable and the training opportunities were very good”. Smug Oak House DS0000019528.V370313.R01.S.doc Version 5.2 Page 21 The rota was checked on the day of this inspection and the service demonstrated that adequate staffing is provided on both day and night shifts. Additional staff are provided where and when appropriate. The service is currently providing 1:1 support to one service user who is presenting with severe challenging behaviour. The service has recruited into one full time support worker post and there are a further 1.5 whole time equivalent post currently vacant. The manager is supernumery to these staffing levels. The recruitment records of 3 staff, including the most recent appointment were viewed; evidence demonstrates that there are good recruitment practices within this service, which means that people living at the Smug Oak House can be reassured they are protected by the effective recruitment systems in place. Smug Oak House DS0000019528.V370313.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): 37, 39, 40 and 42. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People living at Smug Oak House can feel very confident that they are living within a service that is exceptionally well managed. Health and safety systems are in place which ensures people who live and work in the service are protected. EVIDENCE: People living within Smug Oak House are provided with excellent information that has been produced in a pictorial format and can therefore be easily understood in relation to the complaints procedure, Service User Guide, menu planning and support plans. Smug Oak House DS0000019528.V370313.R01.S.doc Version 5.2 Page 23 The manager ensures that supervisions and staff training are held regularly and two staff spoken to on the day of this inspection staff confirmed that they feel very supported and respected by the current manager. People are safeguarded from harm by the homes recruitment procedures, safeguarding training and the complaints procedure. The manager is in the process of further developing the quality assurance system in all areas of the service in order to ensure there is regular monitoring and reviewing to improve areas of development, with a particular focus on service user involvement. All records inspected were secure and were up to date and held in accordance with the Data Protection Act 1998 ensuring that people’s rights and best interests are safe guarded by the homes polices and procedures. Individual and generic risk assessments have greatly improved and have been further developed to ensure people living at Smug oak house are safe and protected. The general standard of fire checks/recording is excellent and fire records on the day of the inspection were up to date and recorded accurate. There are systems in place in order to ensure that everyone living, working or visiting this service are protected from cross infection. The inspector would like to thank the people living at Smug Oak House and the staff who worked tirelessly to provide a service that has greatly improved since the last key inspection was carried out in March 2008. Smug Oak House DS0000019528.V370313.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 3 2 3 3 3 4 3 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 x 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 x 4 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 3 3 4 x 4 x x 4 x 4 x Smug Oak House DS0000019528.V370313.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Smug Oak House DS0000019528.V370313.R01.S.doc Version 5.2 Page 26 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 Smug Oak House DS0000019528.V370313.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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