Care Home: St Anthony`s Cheshire Home

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What the care home does well The ethos of the homes is to promote participation, social inclusion and valued based practices that ensure equality and diversity. People who use the service are actively involved in the development of their care plan and subsequent reviews, to ensure that they are able to live a lifestyle of their choice. Good background research and risk assessments ensured that people were able to have a meaningful social life with valued life experiences. People had access to leisure services within their local community and were provided with the relevant support to have an annual holiday break. People were able to learn new skills to promote their independence, having access to a college located within the home. Comments received from people who use the service are as follows:"The home is very good and the staff are also good." "They are very polite and caring." "Staff do respect our privacy." "The care is OK." "We have very good management support." "The management support is good and she (registered manager) is approachable." "Staff always make us (relative) feel welcome." What has improved since the last inspection? The home continues to provide a service that has good outcomes for people that live at the home. What the care home could do better: With reference to the homes medication practices, it was identified that there were no written protocols in place for the use of `when required` medicines. The registered person should ensure that a written protocol is in place, with regards to when the medicine is required, the dosage, intervals and what actions should be taken if the medicine is not effective, to ensure the health and welfare of people. Information that we, the Commission for Social Care Inspection received from people that lived at the home, would suggest that not all people who accessed the service were aware of the homes complaint procedure. The registered person should ensure that people are reminded of the homes complaint procedure, to ensure their protection and welfare. CARE HOME ADULTS 18-65 St Anthony`s Cheshire Home Stourbridge Road Penn Wolverhampton West Midlands WV4 5NQ Lead Inspector Dawn Dillion Key Unannounced Inspection 23rd April 2008 08:00 St Anthony`s Cheshire Home DS0000022368.V362598.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 St Anthony`s Cheshire Home DS0000022368.V362598.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. St Anthony`s Cheshire Home DS0000022368.V362598.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St Anthony`s Cheshire Home Address Stourbridge Road Penn Wolverhampton West Midlands WV4 5NQ 01902 893056 01902 326376 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.LCDisability.org Leonard Cheshire Disability Mrs Elizabeth Olwen Keenan Care Home 35 Category(ies) of Physical disability (35), Physical disability over registration, with number 65 years of age (12) of places St Anthony`s Cheshire Home DS0000022368.V362598.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st August 2006 Brief Description of the Service: St Anthony’s Cheshire Home is located in Wolverhampton near Wombourne. The purpose built single storey property provides a service for younger and older adults who have a physical disability and general nursing needs. The property is set within its own grounds surrounded with views from neighbouring fields and woodlands. The home consists of 35 single occupancy bedrooms, 26 of which are equipped with en suite. All bedrooms are installed with the necessary aids and adaptations to meet the physical needs of people accessing the service. Lounges and a separate dining area are provided, equipped with essential furnishings and fitments to ensure the comfort of people living in the home. There is a kitchen and a separate laundry in place. Staffing is allocated on a twenty-four hour basis, to ensure the total supervision and support of people accessing the service. Information relating to the fees charged for the service provided at St Anthony’s Cheshire Home was not available; the reader may wish to contact the home directly for this information. St Anthony`s Cheshire Home DS0000022368.V362598.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 2 Star. This means the people who use this service experience good quality outcomes. The unannounced key inspection of St Anthony’s Cheshire Homes was undertaken within a day. The inspection methodologies that were used, to establish the quality of care provided and the effectiveness of the management of the home, to promote equality, diversity and best practices entailed the examination of the records, relating to the homes policies and procedures. During the process of the inspection, seven people that accessed the service, three staff members and two visiting relatives were interviewed as part of the inspection process, to gather an overview of the quality of the service provided by the home. Information contained within the homes Annual Quality Assurance Assessment, questionnaires received from people who use the service and also staff members are incorporated within the contents of this report. A tour of the property was undertaken, to ensure that the environment and systems in operation were safe and conducive in meeting the needs of the people who use the service. The registered manager was present for the majority of the inspection. What the service does well: The ethos of the homes is to promote participation, social inclusion and valued based practices that ensure equality and diversity. People who use the service are actively involved in the development of their care plan and subsequent reviews, to ensure that they are able to live a lifestyle of their choice. Good background research and risk assessments ensured that people were able to have a meaningful social life with valued life experiences. People had access to leisure services within their local community and were provided with the relevant support to have an annual holiday break. People were able to learn new skills to promote their independence, having access to a college located within the home. Comments received from people who use the service are as follows: St Anthony`s Cheshire Home DS0000022368.V362598.R01.S.doc Version 5.2 Page 6 “The home is very good and the staff are also good.” “They are very polite and caring.” “Staff do respect our privacy.” “The care is OK.” “We have very good management support.” “The management support is good and she (registered manager) is approachable.” “Staff always make us (relative) feel welcome.” 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. St Anthony`s Cheshire Home DS0000022368.V362598.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 St Anthony`s Cheshire Home DS0000022368.V362598.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): 1 and 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who may wish to access the service are given the necessary information, to enable them to make a decision to whether the home is appropriate to meet their needs, to ensure their health and welfare. EVIDENCE: There was a Statement of Purpose and a Service User Guide in place that provided essential information relating to the service and provisions available within the home, to enable the individual to establish whether the service would be suitably equipped to meet their assessed needs. Information contained within a service user questionnaire, identified that a person had received pictures of the home to support them in making a decision, to whether they wished to access the service. The registered manager confirmed that these documents were available in a pictorial format and various languages on request. St Anthony`s Cheshire Home DS0000022368.V362598.R01.S.doc Version 5.2 Page 9 There was no information relating to the fees charged for the service at St Anthony’s Cheshire Home. The registered person should ensure that the Service User Guide is reviewed to include this information. The examination of three records pertaining to people living in the home, confirmed that prior to a placement being offered, a pre admission assessment was undertaken, to establish whether the home would be suitable to meet the persons needs, to ensure their general health and welfare. Information contained within the Annual Quality Assurance Assessment stated, “Referrals are taken at St Anthony’s and arrangements are made for all potential new service users to be assessed by either the Service Manager or Care Supervisor.” St Anthony`s Cheshire Home DS0000022368.V362598.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health and personal care that people receive is based on their individual needs. The homes practices promote the individual’s dignity and rights to ensure their general welfare. EVIDENCE: Three care plans were randomly selected for examination, all provided detailed information relating to the care needs of each person and also identified the level of support they required to promote their health, welfare and independence. For example, it was noted that assessments had been undertaken with regards to communication and where necessary people had access to a Speech and Language therapist. With regards to people’s physical disability, there was evidence of the intervention of a Physiotherapist. Continence assessments St Anthony`s Cheshire Home DS0000022368.V362598.R01.S.doc Version 5.2 Page 11 were in place, to ensure that people were provided with the necessary continence aids to promote their dignity and independence. Discussions with people that use the service confirmed that they were actively involved in the development of their care plan and subsequent reviews. The homes practices and procedures ensured that people who accessed the service were encouraged to participate in the management of the home and areas affecting their welfare and lifestyle. Regular meetings were undertaken with people who lived at the home. We looked at some of the minutes of previous meetings, which identified discussions relating to independent counselling services, staffing, college, mealtimes and environmental issues. Discussions with people that use the service confirmed that they were able to make choices, one person told us that, “I am able to go out when I like, the transport service here is very good.” Another person informed us that, “Sometimes I’ve got college classes but in my spare time I sometimes work on my computer, gardening or just listen to the radio.” Risk assessments were incorporated within the care plan, these provided information to enable the individual to take an informed risk, enabling them to live an independent lifestyle. The assessment provided appropriate control measures to reduce or eliminate the risk of harm to the person and staff members. St Anthony`s Cheshire Home DS0000022368.V362598.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): 11, 12, 13, 14, 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 are able to engage in meaningful activities and maintain contact with their local community, to ensure that they have a respected and valued presence within society. EVIDENCE: People who accessed the service were provided with the relevant support and encouragement to maintain and develop new skills to promote their dignity and independence. For instance the service provided a college base within the grounds, teaching floristry, art and crafts, English amongst other subjects. On the day of the inspection a number of people were making waste paper bins for their bedrooms. St Anthony`s Cheshire Home DS0000022368.V362598.R01.S.doc Version 5.2 Page 13 One person was provided with a carer from MENCAP who offered one to one support with their college placement. The setting was warm and welcoming; people were supported with various activities in relation to their abilities and interests. Discussions with a number of people that used the service confirmed that they were provided with the necessary assistance to maintain links within their local community. The home provided the appropriate level of staff and had access to their own specialised vehicles to enable the individual to access leisure services within the community. We spoke to a number of people who informed us of their recent holiday and their plans for this year’s annual break. One person told us that, “I went to Spain last year, it was really good, and I drank a lot of alcohol and let my hair down, what little hair I’ve got.” One person informed us, “I am going to Las Vegas in a few days time” and continued to inform us of his arrangements regarding packing and what staff would be going along with them. Another person told us about a Mediterranean Cruise that they had been on. Further discussions with people who use the service confirmed holidays to Cornwall and Tenerife. Records evidenced other social activities, for example, gardening, dining out, shopping trips, swimming, quiz nights amongst others. The home had an Activities Coordinator who informed us that locations for each holiday were carefully researched and risk assessed, to ensure wheelchair accessibility and that the transport and accommodation could accommodate any necessary aids such as a hoist. The daily routine within the home was relaxed with people having freedom of movement throughout the home and access to all available facilities. One person informed us that, “The home is very good and the staff are also good.” “They are very polite and caring.” “Staff do respect our privacy.” Discussions with a relative who was visiting the home on the day of the inspection, confirmed that there were no restrictions on visiting times and that staff always made them feel welcome. The Annual Quality Assurance Assessment identified that; “Service users are encouraged to keep contact with their families and friends.” “Families and friends are welcomed into the service at any time.” A number of people who lived in the home had young children who were able to visit their parents; the home was proactive in ensuring that not only did the St Anthony`s Cheshire Home DS0000022368.V362598.R01.S.doc Version 5.2 Page 14 staff go through a Protection of Vulnerable Adult (PoVA) clearance but also an Protection of the Children’s Act (PoCA), to ensure the safety of these children. The Activities Coordinator informed us that, “We have just installed two new computers that are going to be equipped with a cam web, this will enable people to maintain closer contact with their families and friends.” We, spoke to one person who lived in the home who confirmed his interest in computers, having had a past career has a Computer Programmer. “I am looking forward to being involved in the development and installation of the computer programmes.” With reference to meals and mealtimes, the home operated a four week menu, providing a variety of choices, discussions with the registered manager confirmed that one person required a vegetarian diet, this information was not incorporated on the menu but there was evidence that the cook would ask this person on a daily basis her requirements which was recorded in a diary, to ensure that this person dietary needs were catered for. Diabetic diets were incorporated within the menu. Discussions with a Registered General Nurse confirmed that “Where necessary referrals will be made for the intervention of a Dietician, Speech and Language therapist.” There were a number of people in residence from the ethnic minority group but no one had any special dietary requirements with regards to their culture or religion. During the process of the inspection we had lunch with a couple of people who lived at the home. One person informed us that, “The meals are very good and the portions are adequate.” However, “Because of my poor memory I am never sure what I ordered the day before.” It was noted that a menu board was on display in the dining room providing information about the choice of meals throughout the day. Another person told us that, “The food is not too bad they do their best.” Staff members were observed interacting with people whilst assisting with eating and drinking, the atmosphere was warm and welcoming. St Anthony`s Cheshire Home DS0000022368.V362598.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. The health and personal care that people receive, reflects the assessed needs of the individual, to promote their general health, safety and welfare. EVIDENCE: St Anthony’s provided a service for younger and older adults who have a physical disability, some of who required some nursing intervention. Care plans provided detailed information about how to promote the privacy, dignity and independence of the individual. For example a number people that were spoken to, confirmed that they were actively involved in the development of their care plan and reviews. Care plans also evidenced that information shared by families in relation to the individuals care needs was incorporated within the plan of care. Care plans also provided information relating to peoples preferences or where necessary what staff were needed to assist the person with their personal care. Discussions with people who accessed the service and general observations St Anthony`s Cheshire Home DS0000022368.V362598.R01.S.doc Version 5.2 Page 16 confirmed that people were able to awake at times of their choice; mealtimes were flexible, so that people were able to have their breakfast at anytime within reason. Three care plans that we looked at, provided sufficient evidence that people’s healthcare needs had been assessed and recognised. Records demonstrated that people had access to relevant healthcare professionals such as physiotherapist, occupational therapist, general practitioners, consultants, opticians and dentists amongst others. Records were maintained of all healthcare visits. One person who lived at the home informed us that, “The care is OK.” The Annual Quality Assurance Assessment stated that, “Service Users are encouraged to challenge staff when they want care carried out in a different way.” This was confirmed by one person who lived at the home who informed us that, “I am always telling the staff off.” When we asked why, they replied, “Because they don’t do it the way I want them to.” With reference to the homes medication system and practices, the Boots Monitored Dosage method was in use. The storage, administration and recording of medicines were reasonably. The registered person should ensure that a protocol for the use of ‘when required’ medicines are in place and that medicines are stored in accordance to the manufactures instructions, to ensure the health and safety of people receiving medicines. St Anthony`s Cheshire Home DS0000022368.V362598.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 who use the service are able to express their concerns/complaints. Policies, procedures and practices ensure that people are protected from abuse to guarantee their general welfare. The lack of staffs understanding of safe guarding procedures could impinge on the safety of people who live in the home. EVIDENCE: The homes complaints procedure was clear and accessible to people who lived in the home. Information about the complaint procedure was also identified within the Statement of Purpose and the Service User Guide. A leaflet called, “Have your say,” “how to make suggestions or complain,” informed people of how to follow the complaints procedure. Information received from a questionnaire identified that, “If I am not happy I would speak to the management staff.” However, there were a few comments that would suggest that not all people were sure what to do if they had a complaint. The registered manager should ensure that all people accessing the service are reminded of the complaints procedure. We have received one anonymous complaint about the home relating to the conduct of one of their staff. Discussions with registered manager confirmed St Anthony`s Cheshire Home DS0000022368.V362598.R01.S.doc Version 5.2 Page 18 that this had been addressed appropriately before we had made contact with the home about this complaint. The home had a safe guarding policy in place; people accessing the service were also issued with a leaflet about “Protecting Vulnerable Adults,” “Guidance for Service Users.” Discussions with two staff members would suggest that further training within this area was necessary, to ensure that they are aware of the current protocol to follow in the event or suspicion of abuse, to ensure the protection of the people living in the home. The registered manager informed us that she had received an allegation from a healthcare professional in relation to a person who lived at the home. The registered manager had followed the appropriate procedures to ensure the safety of the identified individual. St Anthony`s Cheshire Home DS0000022368.V362598.R01.S.doc Version 5.2 Page 19 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, 25, 27, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The design and layout of the home enable people to live in a safe and comfortable environment, promoting their independence and welfare. EVIDENCE: St Anthony’s Cheshire Homes is located in Wolverhampton near Wombourne and is accessible via the A449. The home is set within its own grounds surrounded by neighbouring fields and woodlands. The purpose built single storey property provided accommodation for 35 people, having single occupancy bedrooms, 26 of which were equipped with en suite. All bedrooms were spacious to accommodate wheelchair users and the necessary aids and adaptations to promote the individuals independence. St Anthony`s Cheshire Home DS0000022368.V362598.R01.S.doc Version 5.2 Page 20 Bathrooms and toilet areas were fitted with specialist aids, such as an assisted bath, grab rails and nurse call alarms. Electric switches, work surfaces and equipments were designed and installed to assist people with a physical disability. There was an activity room equipped with computers, people also benefited from a physiotherapy room that was installed with specialist equipment to promote daily exercise. A kitchen and a separate laundry were in place. People living in the home had access to surrounding gardens and a courtyard. Ample car parking was available within the grounds. The hygiene and cleanliness of the home was of a good standard. Information received from a questionnaire confirmed that, “We’ve got a good teams of cleaners here.” St Anthony`s Cheshire Home DS0000022368.V362598.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 and 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in the home benefit from a trained, skilled workforce, that are provided in sufficient numbers to ensure that peoples assessed needs are catered for appropriately. EVIDENCE: There was a positive comment in staff training and development, the examination of training records and discussions with staff members confirmed that they had received the following training within the last twelve months: Fire Marshall, Health and Safety, First Aid, Food Hygiene, Moving and Handling, Prevention of Adult Abuse and the Protection of the Children’s Act. Discussions with one person who used the service expressed that, “The home is very good and the staff are also good.” “They are very polite and caring.” A comment received from a service user questionnaire stated, “Some staff listen others don’t, their body language shows that they are not interested.” St Anthony`s Cheshire Home DS0000022368.V362598.R01.S.doc Version 5.2 Page 22 Discussions with the registered manager confirmed that she was aware of this concern and informed us that it had been addressed in a staff meeting. The homes recruitment procedure ensured that staff members were subject to the necessary safety checks, to guarantee that people living in the home were protected from abuse. We looked at three files pertaining to staff members who had recently been recruited, these evidenced that the appropriate safety checks had been carried out, prior to the person commencing employment. Information obtained from the Annual Quality Assurance Assessment stated, “Service Users are encouraged to get involved in the running of the home and are involved in the interviews for new staff.” We looked at a number of staff records that provided sufficient evidence that staff were provided with regular supervision, to provide them with the relevant support to ensure that an effective service is delivered, to meet the needs of people living in the home. St Anthony`s Cheshire Home DS0000022368.V362598.R01.S.doc Version 5.2 Page 23 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 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management style is open and transparent to promote peoples rights, independence and to ensure a quality service delivery. EVIDENCE: The registered manager was experienced in social and healthcare and had obtained the necessary qualifications with reference to her role and responsibility. The management style was open and transparent and she demonstrated a sound knowledge of the needs of people within her care. St Anthony`s Cheshire Home DS0000022368.V362598.R01.S.doc Version 5.2 Page 24 One staff member informed us that, “The management support is good and she is approachable.” Another staff member told us that, “We have very good management support.” With reference to quality assurance, records evidenced that a representative of Leonard Cheshire undertook regular inspection visits, to monitor the quality of the service delivery. “Monthly Monitoring Visits Performa’s” identified the inspection of the environment, staffing, health and safety and also evidenced that discussions were held with people who lived at the home. With regards to systems that promote the health, safety and welfare of people living in home, safety records were maintained of the servicing of equipments and the general environment, to ensure the protection and safety of people who accessed the service. St Anthony`s Cheshire Home DS0000022368.V362598.R01.S.doc Version 5.2 Page 25 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 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 3 26 X 27 3 28 X 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X St Anthony`s Cheshire Home DS0000022368.V362598.R01.S.doc Version 5.2 Page 26 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. 1. 2. 3. 4. Refer to Standard YA1 YA20 YA20 YA22 Good Practice Recommendations Information relating to fees charged for the service and provisions should be identified within the Service User Guide. To ensure that medicines are stored as per the manufactures instructions. A protocol for the use of ‘when required’ medicines should be developed and implemented. To ensure that all people who access the home are aware of the homes complaint procedure. St Anthony`s Cheshire Home DS0000022368.V362598.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection West Midlands West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway Birmingham, B1 2DT 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 St Anthony`s Cheshire Home DS0000022368.V362598.R01.S.doc Version 5.2 Page 28 - 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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