Care Home: Stokewood

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What the care home does well Some very positive comments have been received from the people using the service. One comment was `the staff are excellent and lovely`. Another said `the staff attitude is good, there is a bit of a banter and that there was a `nice atmosphere`. We noted supportive and positive encouragement from the staff during the visit to the service and respectful relationships with people living in the home who are encouraged to make choices and have opportunities to discuss matters important to them. People using the service are positive about their needs being met and the support that they have with their individual mental health problems. Staff members are given training in relation to the specific needs of people living at Stokewood but can also gain wider knowledge such as in other mental health issues. Staff members are also provided with regular support and supervision. Involvement in activities is developed base on individual needs and wishes and the home is working towards improving opportunities available for use of the community. Independence use of the community is encouraged where possible.The management are interested in promoting the needs and wishes of the people living at Stokewood and have development plan for improving the service further. What has improved since the last inspection? Four requirements were made after the last inspection of this service in relation to, admitting people whose needs have been assessed, needs being kept under review, people have access to health care professionals and holding information in the home about pre employment checks for staff. All of these requirements have been met. What the care home could do better: No requirements have been made in this inspection report. However, a recommendation is included about ensuring that details of outcomes of all adult protection referrals are fully recorded. Also it is recommended that the laundry room be made freely available to people living in the home unless a risk assessment indicates a risk to people. It is also recommended that more information is available about the rules agreed with people living in the home including: the aims and purpose and rights, dates of review and who is involved. In addition, it is recommended that the home takes a more detailed individual approach to responsibilities for the personal finances of people living in the home and discusses again the provision of lockable storage for people living in the home. CARE HOME ADULTS 18-65 Stokewood 204 Hunts Pond Road Titchfield Common Fareham Hampshire PO14 4PJ Lead Inspector Sue Kinch Key Unannounced Inspection 26th February 2008 10:00 Stokewood DS0000055847.V357080.R03.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 Stokewood DS0000055847.V357080.R03.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. Stokewood DS0000055847.V357080.R03.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Stokewood Address 204 Hunts Pond Road Titchfield Common Fareham Hampshire PO14 4PJ 01489 584759 01489 557289 stokewood@truecare.co.uk Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Truecare Group Ltd Michaela Dawn Russell Care Home 7 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (7) of places Stokewood DS0000055847.V357080.R03.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th September 2006 Brief Description of the Service: Stokewood is part of the Truecare Group managed by C.H.O.I.C.E. Ltd. providing residential accommodation for up to seven women who have mental health issues. Stokewood offers seven single bed rooms all with an en-suite toilet and shower facilities The home is situated on the outskirts of Fareham, along a busy residential road. The property is detached with parking spaces at the front, and a large established garden to the rear. Community facilities can be accessed by foot, using public transport, or through use of the home’s vehicle. The current range of fees (Client Contributions) is: £1,730.96 - £2,447.51 per month. Stokewood DS0000055847.V357080.R03.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 inspection consisted of a review of the file held at The Commission for Social Care Inspection (the Commission) local office and of an Annual Quality Assurance Assessment (AQAA) document completed and sent in by the manager before the inspection visit. The visit took six hours. Detailed conversations were held with two residents. Each discussion included a staff member for all or part of the time, depending on individual wishes, and a viewing of care plans. Separate discussions were held with three staff members and the manager who was joined by the operations manager for feedback. Parts of the physical environment were looked at and a sample of documents and records required to be in the home were viewed. Responses were received to surveys sent out before the inspection. They were received from 5 residents, 5 staff, 2 relatives, a health professional and a care manager. What the service does well: Some very positive comments have been received from the people using the service. One comment was ‘the staff are excellent and lovely’. Another said ‘the staff attitude is good, there is a bit of a banter and that there was a ‘nice atmosphere’. We noted supportive and positive encouragement from the staff during the visit to the service and respectful relationships with people living in the home who are encouraged to make choices and have opportunities to discuss matters important to them. People using the service are positive about their needs being met and the support that they have with their individual mental health problems. Staff members are given training in relation to the specific needs of people living at Stokewood but can also gain wider knowledge such as in other mental health issues. Staff members are also provided with regular support and supervision. Involvement in activities is developed base on individual needs and wishes and the home is working towards improving opportunities available for use of the community. Independence use of the community is encouraged where possible. Stokewood DS0000055847.V357080.R03.S.doc Version 5.2 Page 6 The management are interested in promoting the needs and wishes of the people living at Stokewood and have development plan for improving the service further. 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. Stokewood DS0000055847.V357080.R03.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 Stokewood DS0000055847.V357080.R03.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): 1,2,4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Systems are in place to assess needs and aspirations of people wishing to live at the home before admission. EVIDENCE: Following the last inspection a requirement was made in the report to ensure that only people whose assessed needs can be fully met, are admitted into the home. It had been found that the home had not been able to access all relevant health support needed for someone most recently admitted. At this inspection the issues were discussed with the manager and the records obtained for a more recently admitted person were viewed. This showed that the homes procedure had been fully implemented. They demonstrated that the home had obtained pre admission assessments and details through attending a review meeting, by carrying out a review, obtaining a transition plan and additional information before the person was admitted and there were records to show that these needs have been reviewed by the ongoing care team involved. People living in the home said in the surveys that they were provided with enough information about the home before moving in. Those spoken with during the visit were aware of the statement of purpose for the home and gave Stokewood DS0000055847.V357080.R03.S.doc Version 5.2 Page 9 details of some of the information contained in the document such as the training that staff receive. There are some houses rules recently, reviewed by the people living in the home, which the manager says is provided with the statement of purpose and had recently been discussed with a prospective member of the household. Further issues concerning rules are referred to in the lifestyle section. Stokewood DS0000055847.V357080.R03.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): 6,7,9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at the home are involved in reviewing their care needs, risks and support received, and are assisted to make decisions about their lives. EVIDENCE: Each person has a very detailed care-plan folder relevant to them and two of these were looked at whilst talking about the care received with people using the service. They said that they know about the care plans and the range of information that was written in them and have contributed and feel consulted. A member of staff said that it was and ‘open working situation’ and people can see their files whenever they wish to. We looked for a sample of information in care plans relating to some of the issues raised and these were recorded. The requirement in the last report to ensure that assessed needs are kept under review has been met. People living at the home are aware of the regular reviews and agreed that they are discussed with them in monthly support sessions and that they reflect their needs. They said that there are key teams Stokewood DS0000055847.V357080.R03.S.doc Version 5.2 Page 11 of staff for each person and that they feel that they receive the support that they need from them, or other staff. This was also supported by information in the written feedback from the people living in the home. Evidence was also viewed of processes used to encourage emotional self-help. The files contain evidence of regular and recent Care Programme Approach reviews and people knew about the frequency of them and are involved in the process. The manager said that all risk assessments and restrictions are discussed at these reviews. Care plans include elements of risk relating to individuals over a range of activities and where sampled restrictions have been recorded and guidance is also in the care plan. An example was discussed with staff member who pointed out the rights of the persons receiving the service and that this affected action taken by staff. Restrictions were reported by the manager to be agreed with care managers and to be negotiable on a day-to-day basis with people in the service. The staff are trained in the use of restraint and a member of staff, in respect of one person, said that a physical intervention is recorded in the care plan but is rarely used, prone restraint is not used and training is received in physical interventions. Stokewood DS0000055847.V357080.R03.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17, 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 staff members providing and developing opportunities to, take part in suitable activities, access the community and to maintain relationships. Residents’ rights and responsibilities are recognised in the daily routines of the home and meal planning promotes choice and healthy eating. EVIDENCE: People living in the home, staff and the manager gave information about how support is given by staff to be occupied and stimulated. Activities that people were involved in during the inspection were visiting Fareham, shopping and cooking a meal for a friend, being at work and doing a cycling proficiency course, attending a Mind drop-in session, and going to college independently. Staff said they support people in the community depending on assessed needs and on emotional needs of people. During the visit some people were out of the home supported by staff and others, were out independently. Stokewood DS0000055847.V357080.R03.S.doc Version 5.2 Page 13 Feedback from people living in the home included agreement that the home arranges activities that they can take part in. The manager and staff said that support is given in person centred way and this is reflected in the comments from people living in the home and in the care plans. Support is given with such things as cooking, gardening and computer use. Other activities that people are involved away from the home include water aerobics, cinema, swimming, walking, and people spoke of having a holiday in the last year in Devon. They said they are also supported to develop personal interests. Staff said that some funds are available for staff costs in supporting people in the community and support is also given with budgeting. Staff spoke of one person being assisted to move to more independent accommodation later in the week of the inspection visit. The home has a vehicle to provide transport to people but those able to be independent are encouraged where possible to use public transport. Help is given with maintaining relationships external to and within the home. Regular residents meetings are held. Staff said that supporting each other is encouraged among people receiving the service. One person spoke of being assisted to visit a relative in another part of the country. People living in the home are involved in the running of the home and rotas for cooking and cleaning have been agreed. Staff and residents said that there is some flexibility with these and if residents don’t keep to it staff do it. The rules in the home have recently been reviewed and include twenty-one items. People spoken with said they agreed with the rules and said that they were helpful. It was noted that some of the rules potentially limited the choice of individuals such as restrictions on smoking times and where mobile phones are held at night .The manager said that these arise from risk assessments for individuals and are flexibly applied so, for example, if someone needs to smoke at night they can. She said that the people living in the home had recently requested to review the rules, that the rules are negotiable and that care managers are kept informed of changes. It was recommended that how these house rules are used, is clearly explained in the service users guide and that evidence is held of reviews and agreements. The home has a menu plan based on the wishes of the people living in the home. They said that most people are involved in cooking meals in turn through choice. One person chooses to cook separately. Verbal and written feedback confirmed that people living in the home like the food. Stokewood DS0000055847.V357080.R03.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are provided with support to meet their varying health and emotional needs in a supportive and enabling environment. The home’s policies and procedures ensure the safe administration of service users’ medication and promote their independence. EVIDENCE: Where support is needed for personal care this is documented although a staff member said most people are independent in self-caring tasks. They said support is based on needs, is provided flexibly depending on current emotional needs. A care-plan viewed had details of support required. People living in the home said that they receive the care and support they need with health. Those spoken with said that there is good support with physical and emotional health. Examples were provided of how the staff have helped with specific issues including involving external professionals when needed. Care plans include the issues, objectives and support needed to meet these needs and for times of deteriorating mental health. People were supported as they wished during the inspection and said that they are able to Stokewood DS0000055847.V357080.R03.S.doc Version 5.2 Page 15 talk to staff as needed. A comment was received that some of the staff had worked in the home for some time and this helps understanding of their needs. Staff, the manager and people living in the home spoke of support from external professionals in meeting needs and the benefits of opportunities to have support from people outside the home. In the last inspection report the manager was required to ensure that each person who uses the service has access, where necessary, to treatment, advice and other services from any health care professional. Diabetic clinics, dentistry, opticians, community psychiatric nurses, psychiatrists, GPs were referred during the visit to and in the sample of records viewed evidence of health involvement and appointments were documented as required. Involvement of the company’s psychology assistant and experiences of cognitive behavioural therapy were spoken about favourably. One person was looking forward to starting a new therapeutic treatment. People using the service are encouraged to make their own health appointments and a staff member spoke about providing phone numbers for this purpose. Support is provided for going to appointments but some people attend appointments on their own depending on the issues and their needs at the time. One person living at the home gave an example of this. Encouragement is also given to people using the service to cancel their own appointments when needed. The manager, staff, and people using the service, discussed the training in a range of mental health issues staff are provided with, including self-harm, schizophrenia, depression, obsessive compulsive disorders and personality disorders. They also provided examples of training provided for understanding physical health needs such as epilepsy, diabetes and medication. One member of staff has the responsibility of over-seeing medication in the home, recording receipt of medication and checking stock. Samples were viewed. Self-medication is encouraged but some is administered. Risk assessments for involvement in self-medication are in place, although needed to be extended to include when medication is taken out for the day. Other risk assessments are in place in relation to medication for individuals. Obtaining a copy of the revised Royal Pharmaceutical Society guidance was discussed with the manager for guidance about when medication is taken out of the home. Medication is held securely and records are held of administration. Staff were noted to administer medication privately. Records are held of administration and a separate sheet is in place for people using the service to also record that they have received it. Staff said that ‘as required medication is prescribed by the doctor and gave details of guidance to follow. Stokewood DS0000055847.V357080.R03.S.doc Version 5.2 Page 16 Some staff are involved in drawing insulin and a member of staff said that this was following guidance from the diabetic nurse and that it is documented. Stokewood DS0000055847.V357080.R03.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): 22,23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at Stokewood feel listened to and have systems to use if they have concerns and complaints. Policies and procedures are in place to aid the safeguarding of people living in the home. EVIDENCE: The home has a complaints procedure, which is provided in the service users guide that has been provided in a format that people living in the home can understand. They also provided verbal and written information to say that they know who to speak to if they are not happy and know who to complain to. Systems are in place for people to have opportunities to talk with staff regularly. One person said ‘staff are good and supportive’ and another that ‘staff attitudes are good’ and that they felt listened to and not judged. The manager said that there had been no formal complaints since the last inspection although one allegation had been referred under safeguarding adult procedures. This was not recorded in the complaints book but records of the incident and follow up had been recorded. A care plan had been produced as a result of it but although the manager explained the outcome, a record of the response from social services was not recorded. Staff have a rolling programme of training to attend and adult protection is included in this. Although a record of this is held it was not possible to find out exactly how many had been trained. However, the manager has identified Stokewood DS0000055847.V357080.R03.S.doc Version 5.2 Page 18 updates that are needed and can send people on courses throughout the year. Staff are aware of their role regarding whistle blowing and said they have received training in detecting signs of abuse and they demonstrated an awareness of what they should do if they have suspicions. They also showed as awareness of the rights of people living in the home. We asked about the personal financial arrangements for people living in the home and found that money is held in a safe for all people. Records were not viewed on this occasion. The manager agreed that responsibilities could be reviewed on an individual basis and where appropriate lockable storage provided. Stokewood DS0000055847.V357080.R03.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): 24,30 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 enjoy pleasant surroundings that they contribute to keeping clean but access to any area must only be restricted following identification of a risk. EVIDENCE: Areas of the home viewed included all shared areas, the garden and a bedroom. The home was clean and people living in the home say they look after it with staff help. Staff agree and it is their job to do it if the people living the home are unable to or don’t help on certain days. People living in the home say that it is always fresh and clean. Areas viewed were decorated to a good standard and in the bedroom viewed there was evidence of personal belongings. Staff and people, living in the home spoke of the refurbishment before the last inspection and that people had been involved in choosing aspects of the décor. An external professional commented on there being a good ‘decorative environment’. Stokewood DS0000055847.V357080.R03.S.doc Version 5.2 Page 20 People also have access to a large garden allowing additional space for recreation and personal space and those interested are supported to be involved in gardening and to grow vegetables. Plans are in place to re-design the summerhouse to can be used as a hobby room. The manager said that it should be complete by early spring 2008. There is an infection control policy for the home and in the AQAA the manager said that four staff had been trained .She said that more staff are about to undertake a distance–learning course in March 2008. A laundry is available for use and people living in the home have access to it. Each person has a day when they can have priority for use of the washing machine but one person said that could do washing on any day. Access to the laundry is restricted and the manager said that this was because of storage of substances hazardous to health that is not locked in a separate cupboard and because it had always been locked. A discussion took place about not restricting access to people unless there is a risk and the manager agreed to consider action. Stokewood DS0000055847.V357080.R03.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): 32,34,35,36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at Stokewood receive support from a well-organised, effective, supervised, regularly trained and supported staff team. Recruitment processes ensure that people living in the home are safeguarded by the pre-employment checks of staff. EVIDENCE: In the last inspection report a requirement was made about ensuring that staff recruitment records, or a pro-forma agreed with the Commission, were held in the home. Staff returning surveys have reported that checks such as Criminal Record Bureau checks and references were obtained before employment. There is now an agreement with Truecare that records can be held at the main office but there is evidence of recruitment checks in the form of the Commissions proforma at Stokewood. We looked at a sample of these held for three staff recruited since the last inspection and satisfactory information was provided to indicate that the checks took place before they were employed. Written and verbal feedback about staff levels was received indicating that there is enough staff to meet people’s needs. Staff and people using the Stokewood DS0000055847.V357080.R03.S.doc Version 5.2 Page 22 service said that there were always or usually enough staff. One said that there were normally two staff working from 8am-8pm, two doing an eight-hour shift and the manager with two more staff awake from 8pm until 8am. This was reflected in the sample of rotas viewed. One staff commented that in the evenings this meant that sometimes people may have to wait for support but that needs were usually met, staff levels were flexible and could be increased if needed. Staff members were positive about the training and support they receive in the home. In written and verbal feedback they confirmed that they have up to date training relevant to their role and to meeting the needs of the people living at the home. They confirmed that they have induction, monthly supervision and information is shared between them. They also have a range of regular meetings. Evidence is recorded of the training that staff are given and includes a range of care issues such as various courses in mental health, managing behaviours including physical interventions specific health issues such as diabetes and epilepsy, a range of health and safety courses such as fire, first aid and food hygiene and staff are encouraged to be assessed at National Vocational Qualification (NVQ) levels in care and also in mental health. The manager reported that some staff were undertaking training in medication and others in mental health. Also one was being assessed to NVQ level two and another to level three. Two were on the learning disability induction course. A staff member spoke about plans to do a risk assessment course and infection control. Another gave details of training received in the last year. People living in the home are aware of the training that staff have and have at times been involved. The manager has records of the updates of training needed by staff although they did not state clearly when these were needed. However in samples checked with more detailed records it was found that staff had been identified for further training before their existing training was out of date. This included training in use of physical interventions. There is a plan of training sessions for staff and the manager spoke specifically of plans to cascade training on the Mental Capacity Act 2005, of training in different approaches to physical interventions in May 2008 and of adult protection training planned. Stokewood DS0000055847.V357080.R03.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): 37,39,42 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 well run home with a manager that seeks their views and promotes their health, safety and welfare. EVIDENCE: The registered manager has several years of experience of managing this home and has completed the Registered Managers Award (RMA). She is nearing completion of her NVQ level 4 in care and says that she receives regular training the most recent being on the Mental Capacity Act 2005. Throughout the inspection visit it was observed that the management approach of the home is creating an open and inclusive atmosphere. However, recommendations about access to the laundry, the financial responsibilities Stokewood DS0000055847.V357080.R03.S.doc Version 5.2 Page 24 people living in the home, and the rules of the home, are identified in other sections of this report. People living in the home and the staff say they are able to discuss matters as needed. Residents and separate staff meetings are held for this purpose as well as individual support sessions, and day-to-day discussions. Staff members say they feel supported by the manager and people living at Stokewood said they are involved in decisions. We noted that there are records of regular monitoring visits to the home by a representative of the organisation under regulation 26. The manager said that findings of the recent quality assurance surveys, which included consultation with people living at the home, staff, relatives and external professionals, have been fed back to the people living in the home and the staff. Conversations throughout the inspection process have shown us that consultation does take place and that staff and people living in the home feel that they are contributing to the service. The manager said that changes being made from consulting with people using the service includes, developing vegetable plots, developing the use of the summerhouse and increasing the range of activities offered. Through discussion and observation we noted developments of these during the site visit. Following this visit the manager supplied a copy of the homes current development plan, which runs until October 2008. Staff members receive training and updates in mandatory health and safety subjects as part of the rolling programme of training. This includes First Aid, Moving and Handling, Food Hygiene and Infection Control. Fire training was last completed in October 2007. The manager has file of checks within the service and a sample was looked at. It was noted that checks of the electrical wiring and gas had been completed as necessary. Hazardous substances were stored in a locked are as required. One person living in the home has responsibility to assist with fire checks and has completed a health and safety course. Stokewood DS0000055847.V357080.R03.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 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 36 3 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 14 15 16 17 3 x 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 3 x x 3 x Version 5.2 Page 26 Stokewood DS0000055847.V357080.R03.S.doc 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 Refer to Standard YA23 Good Practice Recommendations To ensure that where safeguarding issues are referred under local procedures responses from social services are documented in the home. Stokewood DS0000055847.V357080.R03.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Stokewood DS0000055847.V357080.R03.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. 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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