Care Home: South Highnam

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What the care home does well People had good things to say about the staff. A family member wrote: `My relative could not have a more loving home and deeply caring staff.` Most relatives said that they are happy with the service this home provides. One commented: `It is a home from home.` The service is good at providing information to the people who live in the home in ways that are easier to understand than just written words in English. This tells them what will happen every day and what the staff will do for them. The home is clean and warm and comfortable. It has a lovely garden and is near a park. People have their own rooms and choose the things they have in them. Most people seem to be happy with their rooms. The home provides a service for men and women and people of different ages. The people who work there are men and women and different ages. So they are like the service users in some important ways. Some of the staff have had extra training so that they know how to treat people fairly and understand the ways that they are different. What has improved since the last inspection? The home has made the changes that the last inspection report said it should. They are careful not to keep more medicine than the people need. There are new carpets and floor covering in some rooms and a new worktop in the kitchen. Repairs have been done and some rooms have been decorated. There have been improvements to the building to keep people safer. Staff have had more training. What the care home could do better: The guidelines that the home gives to staff must be checked regularly, to make sure that they are up to date and still work for the people and the service. It is not easy for people who live in this home to go out and about in the community, especially if they need staff help or special transport. Some people cannot go upstairs and some people need more help than others, with personal care or transport. Each person should be given the individual attention and support they need, so that they are included in the social life of their community. People should be offered choices at meal times, even though staff may already know what they like and dislike. This is because people should be reminded that they can choose and it is okay to change your mind. All staff should have training so that they know why and how to treat people fairly. They need chances to learn about the ways that people are different. And staff need to know how they can show that they respect people and can help them to lead full and happy lives. Some people cannot say what they want or speak up for themselves. And they may not be able to answer questions on surveys. The home should not just rely on staff`s views about what people like and dislike, even though they may know them very well. It should ask advocates to help people who cannot answer questions, or write, to give their views on the service. CARE HOME ADULTS 18-65 South Highnam Park Avenue Hartlepool TS26 0DZ Lead Inspector Michaela Griffin Unannounced Inspection 13th December 2007 09:30 South Highnam DS0000021748.V356864.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 South Highnam DS0000021748.V356864.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. South Highnam DS0000021748.V356864.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service South Highnam Address Park Avenue Hartlepool TS26 0DZ 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) 01429 864848 londonroad@tiscali.co.uk Milbury Care Services Ltd Carole Stephenson Care Home 8 Category(ies) of Learning disability (8) registration, with number of places South Highnam DS0000021748.V356864.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th January 2007 Brief Description of the Service: South Highnam is a large detached house in a quiet, residential area of Hartlepool. It is within a short bus or car journey from the town centre and close to Ward Jackson park. The home has eight single bedrooms all with their own hand basins, and a large comfortable living room and dining-kitchen. People who use wheelchairs can move about the ground floor of the house because there is plenty of room, the doors are wide enough and there are ramps for the front door and the door into the back garden. They can also use the ground floor bathroom, which has a special bath so that they can get in and out more easily. There is a games room upstairs and another bathroom with a separate shower. The house has its own grounds, with a car parking area at the front and a sheltered, well laid out back garden. The home is registered to provide care and accommodation for up to 8 people who have a learning disability. The fees charged depend on the needs of the people and the service that they get. They currently range from £935.79 to £1377.43 per week (December 2007). Individuals also make a contribution from their Disability Living Allowance (mobility) of £8 or £25 for travelling in the home’s own minibus. They also pay extra for personal items or holidays and additional services, like chiropody. South Highnam DS0000021748.V356864.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over two weeks. The inspector spent eight hours altogether. She visited the home, talked to people on the telephone after the visit and read what people had written about the home. The inspector sent out surveys to people who live in the home and their relatives to find out what they think about the home. Five service users filled in the survey forms, with the help of staff. Eight relatives also returned surveys. The inspector visited the home and looked around. She met five people who live there and three care staff and the manager. She checked records and paperwork. An ‘Expert by Experience’ helped. An ‘Expert by Experience’ is a person who, because of their shared experience of using services, and/or ways of communicating, visits a service with an inspector to help them get a picture of what it is like to live in or use the service. The Expert looked around the home, talked to staff and spent time with service users. The inspector also spoke to an advocate who has visited some of the people who live in the home. What the service does well: What has improved since the last inspection? The home has made the changes that the last inspection report said it should. They are careful not to keep more medicine than the people need. There are new carpets and floor covering in some rooms and a new worktop in the kitchen. Repairs have been done and some rooms have been decorated. There have been improvements to the building to keep people safer. Staff have had more training. South Highnam DS0000021748.V356864.R01.S.doc Version 5.2 Page 6 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. South Highnam DS0000021748.V356864.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 South Highnam DS0000021748.V356864.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): Standards 1 and 2. People who use the service experience excellent quality outcomes in this area. The home provides information in a form that is easy for people to understand and it makes sure it will be able to meet peoples needs by obtaining full information about them before they are admitted. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: The file of the newest service user was checked and staff explained how people are introduced to the home. The home provides information about its services and the choices it offers, in ways that are easier for people who do not read English to understand, with help. The service user guide is in plain English, with pictures, and does not use technical or long words. The home should keep reviewing and revising the information it provides for service users. It should, where possible, keep sentences short and use photographs that service users will recognise. People are not admitted to the home until the manager has obtained all the information she can about their background and needs, including a copy of the community care assessment. She also visits service users to carry out her own assessment. They are invited to visit the home and to stay for a trial period, before they make up their minds to live there. South Highnam DS0000021748.V356864.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): Standards 6, 7 & 9. People who use the service experience excellent quality outcomes in this area. People have detailed care plans that make clear what they need and want. People can make choices in their daily lives. People are encouraged to lead full lives, with support to protect them from harm. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: The records of three service users were checked. Each service user has a care and support plan based on the assessment of their needs and preferences. The care plans are written in the first person, to remind staff that each person is an individual and that it is important that they get the care and help they need, in the way they want it. Care plans have pictures and photographs, to help the person understand what they are about. The care plans include clear instructions to staff, and carers sign each one to show that they have read it. Care plans are reviewed regularly, to make sure that the person’s needs are still being met and that they are still happy with the way the care is given. There were examples in people’s care plans of how service users are encouraged to make choices about how they spend their time. South Highnam DS0000021748.V356864.R01.S.doc Version 5.2 Page 10 The risk of any service user being harmed, through activity in any aspect of his or her life, is assessed. Records of these assessments are kept on the person’s file and so are instructions to explain to staff how they can avoid or reduce risk, without stopping the individual leading an interesting life and doing the things he or she wants. One of the people who lives in this home goes out by himself, because the risk has been assessed and all those involved in his life agree that he can do so safely. Risk assessments are kept up to date. The ones held on the files checked by the inspector had been updated every six months or when a change had occurred. South Highnam DS0000021748.V356864.R01.S.doc Version 5.2 Page 11 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 adequate quality outcomes in this area. People are involved in activities they enjoy, in and outside the home. Service users are encouraged to maintain relationships with their families and friends. Opportunities to be included in the life of the community are limited for some people who need more help and support. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: Each person receives support from staff to take part in activities that suit him or her, inside the home and in the community. They each have a weekly plan to look at and they are provided with a pin board in their rooms, where they can display pictures to show what they will be doing each day. But only one person uses the pin board for this purpose and the others choose to pin other things on that interest them. Individual activity plans show that people do different things in the community and go out regularly. One person’s routine is based on various employment related activities, like working in a shop and learning life skills. Other people South Highnam DS0000021748.V356864.R01.S.doc Version 5.2 Page 12 attend day services. The other daytime activities that some service users enjoy include line dancing, trampolining and horse riding. In the evening, several service users seem to enjoy attending a very popular, local disco every week, where they meet a wider circle of friends and sometimes have the opportunity to form new relationships. They all go out to pubs and clubs occasionally. Some people like to go to shows and concerts. People can travel in the home’s minibus, but only two people who use wheelchairs can use it at a time. The home has its own driver who has also been trained to support people in community activities. He commented on how all activities are arranged to suit the service users ‘Everything is done the way they want things done. When any activities are planned, we ask the residents first.’ Most family members who sent in survey forms seemed to be satisfied with the range of social activities organised by the home and the opportunities provided for community participation. One family member wrote ‘My relative is encouraged but never forced to participate in social events, this all contributes to a meaningful, happy life. He gets to do lots of things that would be otherwise denied him, such as holidays, social events, learning skills, personal care.’ But one person who filled in a survey did not think that a relative got enough opportunities to go out or to be included in activities. There are also things for people to do inside the home, from cooking to tabletop activities and games. On the day of the inspection, one person had baked some cakes for everyone to share. There is a lovely, private garden at the back that is set out so that all the people who live in the house can enjoy it. There is also a games room upstairs with a pool table and other equipment for people to follow their interests, like music and art and crafts. But the people who do not climb stairs can not use this. Some relatives commented that they are always made to feel welcome in the home. The weekend before the inspection, the home had organised a Christmas party, which many family members had attended. One person still had a hat from the party and said that he had enjoyed it. The home is in a tree-lined residential street opposite a park. It blends in with the other large houses close by and this is good because it does not look institutional or out of place. Houses are set back from the road and gardens are fairly private, so people are not bothered by unwelcome attention from neighbours or passers-by and do not bother anyone else, as they come in and out of their home. But it also means that there are not opportunities for the people to live here to meet and mix with their neighbours on a day-to-day basis, although staff try to arrange friendly contact with the residents of another care home and a private household nearby. There is one pub in the area, but otherwise shops and other community facilities are a bus or car journey away. South Highnam DS0000021748.V356864.R01.S.doc Version 5.2 Page 13 The home is not easy to find or get in and out of in a vehicle, with a narrow entrance and limited car parking and turning space needed for the mini-bus. This means some staff and visitors must park on the street, or walk through a, sometimes, lonely area to and from public transport. People eat together in the home’s large dining kitchen and menus are available that show that people get a varied diet, and special needs are catered for. On the day of the inspection, people were given their lunches and drinks, without being offered a choice or a healthy alternative. This may be because the staff know them well and what they like, but they should always ask what people prefer at the time, to remind everyone that they have the right to choose and to change their minds. From observations, it seemed that the staff present have warm, caring relationships with the people who live in the home. On the day of the inspection, most service users appeared to be relaxed and to enjoy the company of the staff. And there was humour and banter amongst the group of staff and service users. But some service users could not ask for and respond directly to this attention, because they do not speak. Staff tried to include them by talking to them and about them, in a very friendly, positive way. But when one member of staff stopped feeding a service user to do something else, she showed that she was not happy with this and did not understand why her meal was interrupted. Staff should have enough time to give each person as much help and attention as they need. This is particularly important at mealtimes, when some people need one to one attention so that they can enjoy their meals at the pace they prefer. The home should make sure that everybody gets a service that is right and has a good life, including the people who need a lot of help, who can not climb stairs and who cannot talk to tell people what they want and think. South Highnam DS0000021748.V356864.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): Standards 18, 19 & 20. People who use the service experience good quality outcomes in this area. People get the support they need, in the way they prefer and their health care needs are met. Medication is handled safely. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: The records checked that the health and personal care that people receive is based on their individual needs. The staff interviewed could describe how they put the principles of respect, dignity and privacy into practice when they give assistance to individuals. Individual care/support plans identify preferences, like the times when service users like to get up and go to bed. The home employs men and women as carers. So, the same gender supports the service users with personal care, where it is possible and preferred, and men do not provide personal care for the women who need assistance with intimate tasks. There are records on file of regular health checks and of visits and recommendations from relevant health professionals including a physiotherapist, mental health nurse and chiropodist. Reports detail how health related care tasks should be provided and any aids and adaptations for personal support. Reviews show that the delivery of care and the use of equipment is monitored. The home has consulted a speech and language therapist for guidance in helping an individual who has difficulties in swallowing South Highnam DS0000021748.V356864.R01.S.doc Version 5.2 Page 15 and could be at risk of choking. Only carers who have had the relevant training and guidance to do this safely should help this person to eat. The home has policy and procedures for the safe administration of medication and these are set out as guidelines in a practice manual, for staff to follow. Records and discussions with staff confirmed that this happens. All staff receive relevant training and their competency is assessed, to make sure that the training has given them the knowledge and skills they need. The recommendations from the last inspection, about not storing more medication than needed, have been implemented. South Highnam DS0000021748.V356864.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): Standards 21 & 22. People who use the service experience good quality outcomes in this area. People are encouraged to express their views about the service and they are confident that they will be taken seriously. They are protected from abuse and harm. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: The home has a complaints policy and service users are provided with picture based, easy to read guidance: ‘Letting us know what you think’. Each service user has an easy to read contact card, with contact details for social services, CSCI and an independent advocacy service. This is to encourage them to feel that they can make a complaint, to someone who is independent and not involved in the service, if they want to. Five of the relatives who returned surveys wrote that they know how to make a complaint, but two said that they do not. The home has not had any complaints in the last year and that could be because some people do not know how to complain. But five of the six relatives who answered the question, wrote that they feel that their concerns are ‘always’ listened to and one said ‘sometimes’. Staff have training in Adult Protection policies and procedures and can demonstrate that they know how to keep people safe and what to do if they think that someone has been or could be harmed through abuse or neglect. The home must review its adult protection policies and procedures and up date them as necessary. This is to ensure that they match local inter-agency agreements about how agencies will work together to safeguard people in vulnerable situations (like care home residents) from abuse and neglect. South Highnam DS0000021748.V356864.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): Standards 24, 28 and 30. People who use the service experience adequate quality outcomes in this area. The home provides a safe, clean, comfortable place to live, with space and equipment that meets people’s needs. But people who use wheelchairs cannot use all the facilities it provides. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: The Expert by Experience looked around the home. Some of the service users, who were there on the day of the inspection, agreed that he could look in their rooms. The Expert commented ‘The residents were able to have a say in how their bedrooms were decorated. The bedrooms were full of the residents’ personal belongings and the residents were able to choose their own furniture’. The inspector also checked that all the repairs and redecoration recommended at the last inspection had been carried out. There are new floor coverings (carpets and vinyl) in some rooms and kitchen worktops have been replaced. The carpet in the kitchen should be replaced next and recent minor damage repaired. The health and safety measures identified in the last report have also been put in place, for example the boiler cupboard door is kept locked and this was confirmed on the day of the inspection. South Highnam DS0000021748.V356864.R01.S.doc Version 5.2 Page 18 The home appears to be clean and comfortable and it is decorated and furnished to a good standard in a pleasant domestic style. The individual bedrooms are a reasonable size and the ground floor bedrooms have enough space for the people who use wheelchairs to move around, get the help they need from staff and to store and use equipment. But there is only one living room on the ground floor and people who use wheelchairs cannot use the upstairs games room. South Highnam DS0000021748.V356864.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): Standards 32, 34, 35 & 36. People who use the service experience good quality outcomes in this area. People are protected by the way that the home recruits and trains its staff. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: The records of new staff had evidence that the home carries out all the checks and gets the references required, before people start work. This is so that the home does not employ anyone who has something in their background that means that they are not suitable to work with people in vulnerable situations (like a care home). The home aims to provide person-centred services, and the principles of choice, individuality, dignity, independence and respect underpin its introductory training for new staff. Two new staff were interviewed and they showed that they understand these principles and have good ideas about how they can put them into practice. Staff have regular one to one meetings with a senior member of staff, who has had training on supervising staff and carrying out annual appraisals. This helps to identify the training and support they need to do their jobs. Five of the relatives, who returned surveys, said that the staff ‘always’ have the skills required, two said ‘usually’ and one said ‘sometimes’. South Highnam DS0000021748.V356864.R01.S.doc Version 5.2 Page 20 The home has an annual training programme. This ensures that all the staff get the basic training they need, to care for people safely, and regular refreshers to keep them up to date. The home encourages staff to achieve Level 2 of the National Vocational Qualification in care. This is the minimum level recommended in the National Minimum Standards for care services. Care workers also do extra training to meet the needs of particular service users. Some of the training that staff receive is ‘on-line’, through the internet, using a special computer in the home’s office called an ‘El box’. This is a good way for individuals be able to get training flexibly, to meet their particular training needs, at times that suit them and the service. Staff also complete assessments ‘on line’, which test if they have learned and understood the information they have been given. But this way of training does not give staff the chance to talk about how they should apply this knowledge in the particular situation of this home and with the particular people who live there. And it does not test if they can put what they have learned into practice. All staff should have training to raise their awareness about equality and diversity issues and how it is important to recognise the ways that people are different but need individual support to lead the lives they want. As well as training and reading policies individually, the manager and staff should talk about how they can make sure that people who need more help than others are always included. Staff should also be encouraged to use only respectful language and talk about service users as individuals. This reminds everyone that each person, irrespective of the level and type of their need for personal assistance, is an adult citizen and the service recognises their dignity and rights. South Highnam DS0000021748.V356864.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): Standards 37, 39 & 42. People who use the service experience good quality outcomes in this area. The home is well managed and run safely. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: The manager is registered with the Commission for Social Care Inspection, so it is clear who is responsible for the day-to-day management of this service and the welfare of service users and staff. She has the relevant qualifications required. She has National Vocational Qualifications in Care and Management (the Registered Managers Award) and has had up to date training on managing risks and health and safety. The agency now has a Regional Quality Assurance Manager and routine monitoring takes place, to make sure that policies and procedures are being followed. Staff carry out regular checks on health and safety issues like fire safety and hot water temperatures and registered contractors certify that equipment is well maintained and working properly. South Highnam DS0000021748.V356864.R01.S.doc Version 5.2 Page 22 The home must ensure that no service users’ views and interests are excluded from its routine quality assurance processes. The home has involved advocates in the past to focus on decisions and issues for particular service users. An independent advocate has represented the views of people who could express them and give instructions. Another advocate has also worked with the service users who are not able to express their views clearly, because they do not communicate with speech, to try to represent their best interests in decision making. One advocate said that he had found that the home allowed him to see individuals in private and let him have any background information he required, to help him understand the individuals and to represent them. The home should involve advocates to support people in completing regular surveys asking their views on the service. It should include and record regular consultation with the advocate for the people who are not considered to have the ability to give instructions, as it is important that their experiences and wishes are incorporated into the home’s quality assurance systems. South Highnam DS0000021748.V356864.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 3 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 3 ENVIRONMENT Standard No Score 24 3 25 x 26 x 27 x 28 2 29 x 30 3 STAFFING Standard No Score 31 x 32 x 33 x 34 3 35 3 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 2 14 x 15 3 16 3 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 x 3 3 x 3 x x 3 x South Highnam DS0000021748.V356864.R01.S.doc Version 5.2 Page 24 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA23 Regulation 13(6) Requirement The home must review its Adult Protection policy and procedures to make sure that it is consistent with the local inter-agency agreements on safeguarding adults in vulnerable situations. The latest version of the multiagency strategy should be available for staff to refer to. Timescale for action 01/04/08 South Highnam DS0000021748.V356864.R01.S.doc Version 5.2 Page 25 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. 2. Refer to Standard YA13 YA17 Good Practice Recommendations The home should check that all service users have the chance to be included in activities inside the home and in the community. Staff should always ask people what they would prefer at meal times, to remind everyone that they have the right to choose. The Registered Manager should ensure that the repair/redecoration and replacement programme continues and should include the replacement of the kitchen carpet. All staff should have training to raise their awareness about equality and diversity issues. They should have opportunities to discuss, with their manager and colleagues in the care team, how they can put the principles of fairness and respect for difference into practice. The home should find ways of routinely including the views and experiences of service users in its systems to assure the quality of the service. 3. YA24 4. YA35 5. YA39 South Highnam DS0000021748.V356864.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS 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 South Highnam DS0000021748.V356864.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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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