Care Home: Streatfeild House

Similar services:

• Thorndene
• Sutton Lodge Nursing Home
• Insight - Eastchurch
• Southfields
• Magenta
• Seabourne House
• 33 St John`s Church Road
• Dovedale Court

What the care home does well There has been no turnover in the staff team since the last inspection and the majority of the staff team have worked in the home for several years. They work well both individually and as a team and this is evident in their approach to record keeping. Continued emphasis is placed on staff training and this means that the staff are well equipped to meet their individual needs. Staff feel well supported. One staff member said that `any problems that occur are dealt with very quickly`, another said that the manager is down to earth and you can speak freely with her. A high percentage of the residents have lived at Streatfeild House for a number of years. They get on well together and this is evident in the way they greet each other at the end of their day and how they interact with each other about their activities. Residents are proud of the individual contributions they make to the running of their home. Staff work hard to enable residents to make informed choices about all aspects of their lives. Comments from residents included that `I like living here`, `the staff treat us well` and `the food is very good`. All residents who choose to have an annual holiday and a number of theatre trips and outings are arranged throughout the year. What has improved since the last inspection? What the care home could do better: Three requirements were made following this inspection. They included the need for the owner to demonstrate that he is monitoring the conduct of the home. A requirement was also made to clarify the procedure for staff to follow in relation to the management of medication for residents when they are away from home. The manager was reminded of the need to report any incident that affects the wellbeing of a resident to the Commission. CARE HOME ADULTS 18-65 Streatfeild House Cornfield Terrace St Leonards-on-Sea East Sussex TN37 6JD Lead Inspector Caroline Johnson Unannounced Inspection 25th January 2008 10:00 Streatfeild House DS0000067677.V358098.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 Streatfeild House DS0000067677.V358098.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. Streatfeild House DS0000067677.V358098.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Streatfeild House Address Cornfield Terrace St Leonards-on-Sea East Sussex TN37 6JD 01424 439103 01424 438842 gillclusker@hotmail.com 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) Streatfeild House Limited Mrs Gillian Clusker Care Home 18 Category(ies) of Learning disability (18), Physical disability (9) registration, with number of places Streatfeild House DS0000067677.V358098.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. The maximum number of service users to be accommodated is eighteen (18). Service users must be aged between eighteen (18) and sixty-five (65) years on admission. All service users will have a learning disability. No more than nine (9) of the service users at any one time shall be physically disabled. 26th September 2006 Date of last inspection Brief Description of the Service: Streatfeild House is registered to accommodate eighteen adults with learning and physical disabilities. It is located in St Leonards in an old rectory, in a quiet narrow terrace, next to a church. The house is of historic interest. Accommodation is on three floors and the property is well maintained throughout. Externally there is a large parking area. A bus service to Hastings and the seafront passes near the home and there are a small number of shops within a short walk. Information about the service, including the Statement of Purpose, Service User’s Guide and CSCI reports is made available to prospective service users or their relatives, on request, as part of the admission process. The current range of fees at Streatfeild House, as of 30 January 2008, is £550 per which includes a day care package. Fees doe not include toiletries, hairdressing and magazines/newspapers. Streatfeild House DS0000067677.V358098.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. We have assessed that people who use this service receive an excellent quality of care. For the purpose of this report the people living at Streatfeild House will be referred to as ‘residents’. As part of the inspection process a site visit was carried out on 25/1/08 and it lasted a full day. The registered manager facilitated the inspection. Over the course of the inspection there was an opportunity to meet with most of the residents. In addition time was spent with two staff members in private. Apart from the basement area all areas of the home were seen during the inspection. A wide range of records was examined including pre-admission assessments for one resident and three care plans. In addition records seen included; staff recruitment and training, medication, complaints, health and safety, quality assurance and leisure activities. Prior to the inspection a range of service user surveys, and comment cards were sent to the home for distribution to residents, their relatives or representatives and any visiting professionals. Comments received included: ‘I have to say that no praise is enough for the staff and management of SH. My brother is given the utmost care and support. My husband and I see him nearly every week to take him out and whenever we telephone are able to speak to him’. ‘Streatfeild House has a friendly, warm atmosphere. From our first visit we were impressed that it seemed very much a home and not an institution’. ‘I have nothing but praise for the running of the house, as I have always been made welcome. The care towards the residents is Tops’. Two less positive comments were received, one relative said they had not been informed that their relative was going on holiday and one relative said they would like to see more staff on duty at night. In relation to the first comment the manager advised that they would revise their procedure to ensure that keyworkers formally write to relatives prior to holidays. In relation to the staffing issue, it was assessed that the current arrangements are sufficient. What the service does well: There has been no turnover in the staff team since the last inspection and the majority of the staff team have worked in the home for several years. They work well both individually and as a team and this is evident in their approach to record keeping. Continued emphasis is placed on staff training and this means that the staff are well equipped to meet their individual needs. Staff feel well supported. One staff member said that ‘any problems that occur are dealt with very quickly’, another said that the manager is down to earth and you can speak freely with her. Streatfeild House DS0000067677.V358098.R01.S.doc Version 5.2 Page 6 A high percentage of the residents have lived at Streatfeild House for a number of years. They get on well together and this is evident in the way they greet each other at the end of their day and how they interact with each other about their activities. Residents are proud of the individual contributions they make to the running of their home. Staff work hard to enable residents to make informed choices about all aspects of their lives. Comments from residents included that ‘I like living here’, ‘the staff treat us well’ and ‘the food is very good’. All residents who choose to have an annual holiday and a number of theatre trips and outings are arranged throughout the year. 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. Streatfeild House DS0000067677.V358098.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 Streatfeild House DS0000067677.V358098.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): 1,2,3,4,5 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents can feel confident that the home ensures that they are able to meet their needs to making a decision about providing accommodation. EVIDENCE: There is a detailed statement of purpose in place. At the time of the last inspection the manager had started work on updating the service user guide to make it more user friendly. At the time of inspection work was still ongoing on this document but it was almost complete. Following the inspection a copy of the updated user guide was sent to the Commission. Since the last inspection two new residents have been admitted to the home. It was reported that in each case there is a contract between the placing authority and the home. A copy of the home’s terms and conditions of residence had been given to either the next of kin or a representative but there were no signed copies in place. Following the inspection the manager confirmed by email that she had obtained signed copies of the document. These will be seen at the next inspection of the home. Streatfeild House DS0000067677.V358098.R01.S.doc Version 5.2 Page 9 Records seen in relation to one of the newly admitted residents showed that a detailed assessment had been carried out prior to the resident being admitted to the home. The resident was invited to the home for an overnight stay prior to making a decision about accommodation and when the decision was reached the home wrote to the placing authority confirming that they could meet the needs of the prospective resident. Streatfeild House DS0000067677.V358098.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): 6,7,8,9 People who use the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The care of residents is enhanced because care plans provide detailed and up to date advice about their needs and abilities. Residents benefit from being encouraged to make choices and decisions about how they want to live their lives. EVIDENCE: Care plans were seen in relation to three residents. There is detailed information provided about the abilities and needs of the residents. Guidelines are in place to ensure that needs are met. When the guidelines need to be updated the date any change is made is typed in a different colour. Detailed risk assessments are carried out in relation to all activities that the residents participate in. In relation to one resident it was noted that following a number Streatfeild House DS0000067677.V358098.R01.S.doc Version 5.2 Page 11 of falls, specialist advice was obtained and the resident now has a zimmer frame. No further falls were recorded following this. Following the last inspection, the home invited Social Services to reviews that they held in-house. Four reviews were attended. Agreement has since been reached that the home will inform Social Services if there has been any major changes to care plans or a deterioration in health. The home continues to update care plans as and when needs change, and in each case a review of the full care plan is carried out on an eight-week basis. When a change is made to a care plan a record of the change is kept in the staff room and when all staff have signed that they have read the change it is then incorporated into the care plan. A notice board in the staff room us used to advise staff where to look to see recent changes. Residents and where appropriate their relatives are also invited to reviews and each resident is given a pictorial copy of their care plan review which they then sign. Personal goals are reviewed during this process and if necessary new goals are set. Residents meetings are held regularly and staff advised that as part of this process staff spend time with each resident individually so that they hear their particular views, choices and decisions. Choices of activities are discussed and they are then built into the plan for activities for the next month. As a result of the residents meetings a new board has been placed in each bedroom showing a photo of the staff on duty on each shift and residents are encouraged to choose who they would like to assist them with tasks such as showering. Information is also included on the board about staff holidays and sickness. It was also reported that the home are about to purchase a package which will encourage residents to use a widget system to make a wider range of choices and decisions in relation matter such as their activities, routines and meals. Streatfeild House DS0000067677.V358098.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): 11,12,13,14,15,16,17 People who use the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents have opportunities to participate in interesting and stimulating activities that are centred on meeting their individual needs and aspirations. EVIDENCE: The majority of the residents attend the day service run via the home and a small number of residents attend day centres in other settings. One of the residents has a work placement. The home’s day centre is run from one of the lounges. A new activity folder has been created for each resident. This includes information about each resident’s needs and aspirations. There is also information about how these can be achieved and where necessary the steps towards achievement are detailed. Reviews will be carried out regularly to monitor progress. If an Streatfeild House DS0000067677.V358098.R01.S.doc Version 5.2 Page 13 activity is not carried out or if the resident declined to participate in an activity this is now recorded. A staff member advised that she has completed a reminiscence course and they have been able to use some of the ideas and tips provided within the day centre activities. Last year one of the activities run in-house was belly dancing and this year as a result of a request from residents they have introduced line dancing. An aroma therapist visits the home regularly to provide a service to the residents. A number of residents go swimming on a weekly basis and recently one of the residents received a certificate in recognition of her achievements. A few of the residents attend evening clubs and arrangements are made regularly for residents to visit local pubs, to have meals out and regular shopping trips. Whilst spending time in the lounge area it was noted that as residents came home from various activities that they had been to throughout the day they were given a genuinely warm welcome from their fellow residents. It was also noted that they were encouraged to talk about their day and what they had been doing. A number of residents were enjoying watching a DVD and it was noted that they enjoyed sharing the pleasure of the film with each other. Residents’ meetings are used to discuss activities, holidays, Christmas fayres etc. The home raised a large amount of money via their fayre and this money will be used on in-house entertainment. Everyone is encouraged to participate in activities about the house. This includes activities such as washing, drying, laying the table and folding laundry. Residents were seen to enjoy participating in these activities and those spoken with confirmed that they like doing jobs about the house. Four of the residents have already planned a holiday to the Isle of Wight. One of the residents spoken with confirmed that he is looking forward to the trip particularly the opportunity to ride on a steam train. Other holidays have yet to be planned but residents advised that they use their resident’s meetings to discuss ideas. The home is also planning a visit to the local fire station as this was requested by one of the residents. Recent outings have included going to the Ice Show at the local theatre and a trip to the war museum in London. A number of the residents spoke about the ice show and about how they had thoroughly enjoyed the show. A comment was received from a relative that they had not been informed prior to their relative going on holiday. The manager advised that the normal practice is that keyworkers inform relatives of holiday arrangements. However, in this case there must have been an oversight. By the end of the inspection, the manager had agreed with staff that in future the home’s policy would be that relatives would be informed in writing of all holiday arrangements. Streatfeild House DS0000067677.V358098.R01.S.doc Version 5.2 Page 14 There is a four-week menu in place, which is varied. The menu plan shows evidence that thought has been given to ensuring that residents are gaining appropriate amounts from each of the main food groups. Staff advised that they introduced photos of each meal to assist in residents making more informed choices but this did not work well. Menus are discussed at reviews and the cook has a list of dislikes and staff also record if residents particularly like a meal. The cook and deputy manager have recently attended a nutrition course. All residents spoken with confirmed that they enjoy the meals served in the home. Streatfeild House DS0000067677.V358098.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): 18,19,20 People who use the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The care of residents is enhanced because there are very good arrangements in place to ensure that their healthcare needs are met. EVIDENCE: Since the last inspection a new audit system has been introduced to monitor medication from the time it is received into the home. A weekly check is carried out to ensure that all procedures have been followed and if any shortfalls are identified then appropriate action is taken. In addition a new system has been put in place to avoid confusion over medications administered outside of the normal administration times. Any unused or out of date medication is returned to the pharmacy on a monthly basis. Records showing medication administered to residents were in order. Within the medication folder there is advice about each medication prescribed, what it is given for and any side effects that could be noted. A number of Streatfeild House DS0000067677.V358098.R01.S.doc Version 5.2 Page 16 homely remedies are stored in the home for use as and when required. The administration of medication procedure was examined and is detailed but the policy on homely remedies section needs to be expanded and a list of the homely remedies in use agreed with individual gps. In addition the medication policy needs to detail more clearly the arrangements to be made for residents to receive medication when they are away from the home. Alternative arrangements have been found for the storing of medications that were previously stored in the basement area. Where residents have a diagnosis of epilepsy, information is included in their individual care plans about the type of seizures experienced by them. In addition staff have received training on the subject and a relative of a resident also attended this training. A requirement was made at the last inspection that information be obtained from a resident’s relative regarding the nature of any seizures experienced by her relative. This has been addressed. Staff observed in the course of their duties were courteous and respectful. The newly introduced charts in each room show the staff on duty and allow residents to make decisions about who will support for them. The home has started the process of completing health action plans for a number of the residents. In each care plan there is a record of all healthcare appointments attended. Records show that individual weight, blood pressure and pulse is recorded monthly. In the files examined it was noted that residents had attended opticians and chiropody appointments. There was evidence in the care plans seen that when specialist advice is needed to meet a residents needs then this is obtained. Streatfeild House DS0000067677.V358098.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): 22,23 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The welfare and safety of residents is promoted because the home has good systems in place to ensure that all complaints and any suspicion or allegation of abuse is dealt with appropriately. EVIDENCE: There were seven minor complaints recorded in the complaint book. In each case the records showed that residents were being listened to. All were recorded in detail and where necessary new guidelines were put in place detailing any action to be taken as a result. Staff spoken with confirmed that they had attended training on the protection of vulnerable adults. Plans will be made for this to be updated during the coming year. The home also has a DVD on the subject and staff are required to view this periodically. It was reported that all new staff have attended a formal training course on the subject recently. It was noted that since the last inspection an adult protection alert was made to Social Services for possible investigation. It was reported that no formal response was received from Social Services but that they advised informally that they were satisfied with the action taken by the home and there was no need for any further action to be taken. The manager agreed to follow this up Streatfeild House DS0000067677.V358098.R01.S.doc Version 5.2 Page 18 so that they have a written record of the outcome. No further incidents were recorded. The matter had not been reported to the Commission. Streatfeild House DS0000067677.V358098.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): 24,25,26,27,28,30 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The ongoing audits and programme for redecoration ensure that the home is well maintained and decorated to a very good standard. This ensures that the residents live in a well maintained homely environment. EVIDENCE: Communal areas consist of two very large lounges and a separate dining room. All areas are decorated to a good standard. The back staircase was being redecorated at the time of the inspection. The front staircase has been redecorated. The manager advised that she carries out a six-monthly audit of the home and an action plan is drawn up detailing any works required as a result. In addition if staff or residents raise issues they are added to the list. As a result of a recent audit a new mattress was purchased for one resident. In addition items of furniture have also been ordered for other rooms. Streatfeild House DS0000067677.V358098.R01.S.doc Version 5.2 Page 20 With the exception of the basement all areas of the home were seen during the inspection. All bedrooms seen were well decorated and have been personalised by the residents. The manager confirmed that the locks have been replaced on the three bedroom doors highlighted at the last inspection. There are plans in place to completely redecorate one bedroom and the ensuite bath will be changed to an ensuite shower at the request of the resident. As there is a washbasin in the ensuite the washbasin in the bedroom will be removed to create additional space. Staff record any maintenance issues they note in a maintenance book and these are addressed as soon as possible. It was reported that the frequency of fire drills has increased but a full evacuation has yet to be carried out this year. Records show that all fire equipment is serviced at regular intervals. All areas of the home seen during the inspection were clean. Staff receive training on infection control as part of their induction to the home. Streatfeild House DS0000067677.V358098.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): 31,32,33,34,35,36 People who use the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A combination of a very stable staff team, good training opportunities and regular supervision ensure that staff remain equipped to meet the needs of the residents accommodated. EVIDENCE: There has been no turnover in the staff team since the last inspection. However, a weekend cook has now been employed, an extra cleaner and an additional part-time carer. Recruitment records were examined and were found to be thorough. An issue was raised in relation to one prospective staff member and the manager confirmed that this had been discussed with the person concerned prior to making a decision about appointment. Each of the new staff is working through a detailed induction package. Records showed that staff receive regular supervision and all staff spoken with confirmed that this is the case. Streatfeild House DS0000067677.V358098.R01.S.doc Version 5.2 Page 22 One relative commented that they felt that there should be additional staff on duty at night. It was noted that when the day staff go off duty there is one staff member in the building providing a waking night duty. However, in addition to this the manager lives on-site so is on call every night. If she were to be out for an evening or away over night then alternative arrangements are made for someone else to sleep in. The majority of the residents require very minimal support at night. The manager advised that she is very rarely called at night. Eight of the seventeen care staff have completed NVQ Level 2 or above and an additional two staff are currently studying for this qualification. All of the staff team have completed mandatory training during 2007. A member of staff either has or is about to attend a train the trainer course in each of the following areas; manual handling, health and safety, first aid and fire safety. Once these courses have been completed the training will then be cascaded to all staff. Staff will complete an assessment, which will be verified by the company that has provided the training and on successful completion a certificate will be issued. Each of the four staff will need to do refresher courses periodically and the company concerned will keep them informed of any changes or updates in current legislation. During the past year a couple of staff received training on oral hygiene and a member of staff spoken with also confirmed that they had been on a nail cutting course. Staff have also received training on the Mental Capacity Act. Staff spoken with confirmed that they receive regular supervision and that they find this very useful. Streatfeild House DS0000067677.V358098.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): 37,38,39,42,43 People who use the service good excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents benefit from living in a well run home. The improvements made to the quality assurance system ensure that the home is continually reviewing and improving upon the way they operate. The care of residents might be compromised because the provider does not carry out his monthly reports on the conduct of the home. EVIDENCE: The manager has completed NVQ Level 4 and the Registered Manager’s Award (RMA). She has managed the home for a number of years and has a wealth of experience in caring for adults with learning disabilities. The deputy manager is currently studying for the RMA. Staff spoken with stated that the manager Streatfeild House DS0000067677.V358098.R01.S.doc Version 5.2 Page 24 is very supportive one staff member stated that ‘any problems that occur are dealt with very quickly’, another said that the manager is down to earth and you can speak freely with her. Hot water temperatures were tested at one outlet and this was above agreed safety limits. The manager confirmed that it would be adjusted that day. The outlet tested is rarely used. Staff confirmed that hot water temperatures are recorded regularly. There were certificates in place to show that portable appliances had been tested and to show that a legionella assessment had been carried out. Quotes have been obtained to get an electrical wiring certificate and the manager confirmed that this work would be carried out this year. As part of the home’s quality assurance system a number of audits have been introduced to monitor performance. Audits are now carried out in relation to medication, cleaning of bedrooms and care plans and where issues have been picked up they have been addressed and where necessary guidelines have been put in place. Residents also complete satisfaction questionnaires. Questionnaires are also available by the front door for relatives and visitors to complete and there is a suggestion box available but both systems are rarely used. The manager advised that she would arrange for the relatives’ questionnaire to be distributed on an annual basis. Residents meetings are held and minutes are kept of the outcome. The home has yet to complete an annual development plan. Prior to the inspection user surveys and comment cards were sent to the home to distribute to residents, relatives and any visiting professionals. Seven comment cards were received from relatives and two visiting professionals completed cards. Comments received included ‘I have to say that no praise is enough for the staff and management of SH. My brother is given the utmost care and support. My husband and I see him nearly every week to take him out and whenever we telephone are able to speak to him’. ‘Streatfeild House has a friendly, warm atmosphere. From our first visit we were impressed that it seemed very much a home and not an institution’. ‘I have nothing but praise for the running of the house, as I have always been made welcome. The care towards the residents is Tops’. As referred to previously in the report the home did not report an incident that affected the wellbeing of a resident to the Commission. However, in this instance appropriate action was taken by the home and no further incidents occurred. A requirement was made at the last inspection that the provider carries out a monthly check of the home and records the result of his findings. This had not been achieved. However, it was confirmed that the owner visits the home at least twice a week and that he spends time talking with residents and staff. It was also evident that when the manager was on leave he participated in meetings that were held concerning residents. Streatfeild House DS0000067677.V358098.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 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 4 32 3 33 4 34 4 35 4 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 3 3 X LIFESTYLES Standard No Score 11 3 12 4 13 4 14 3 15 3 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 2 X 4 4 3 X X 2 2 Streatfeild House DS0000067677.V358098.R01.S.doc Version 5.2 Page 26 YES 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 YA20 Regulation 13(2) Requirement The arrangements for residents receiving medication whilst on leave from the home must be included in the home’s medication procedures. Any matter that affects the wellbeing of a resident must be reported to the Commission without delay. The owner must carry out a monthly check of the home and record the result of his findings. The outcome must be available for inspection. [This was a requirement of the previous inspection timescale given was 30/11/06]. Timescale for action 31/03/08 2. YA42 37 15/03/09 3. YA43 26(2,3,4) 15/03/08 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 YA20 Good Practice Recommendations The home’s homely remedies policy should be expanded DS0000067677.V358098.R01.S.doc Version 5.2 Page 27 Streatfeild House 2. YA39 and a list of regular homely remedies/over the counter medications agreed with individual gps for use as and when required. The relative’s satisfaction questionnaire should be distributed to relatives to formally seek their views on the quality of the care provided in the home. In addition the home’s annual development plan should be updated. Streatfeild House DS0000067677.V358098.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Streatfeild House DS0000067677.V358098.R01.S.doc Version 5.2 Page 29 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!