Care Home: Stroud Court

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What the care home does well The service provides good training for its staff, from induction through to developmental training and NVQs. The service has a motivated and professional staff team with the knowledge and expertise to meet the needs of people with an autistic spectrum disorder. Service users have detailed care plans in place that reflect the complex needs that are to be met. The service places a strong emphasis on communication techniques and strategies to improve the ability of service users to make choices and be involved in decisions relating to their care. There are excellent systems in place to co-ordinate and monitor health and safety, equipment servicing and general maintenance. The service provides a variety of daily activities for people to choose from and regular opportunities for going out into the community. What has improved since the last inspection? Improvements have been made in the variety of activities that can be accessed both in the home and in the community. The individual houses have been given more responsibility for menu planning, shopping and food preparation. An improved induction-training package is now in place for all new staff. There has been a further decrease in the occurrence of incidents that have required physical intervention from care staff. Health action plans are now being developed for all service users. What the care home could do better: Some of the care plans could contain more specific short and medium term goals and objectives, particularly in relation to the development of independent living skills. Senior carers could receive more regular formal and structured supervision. CARE HOME ADULTS 18-65 Stroud Court Longfords Minchinhampton Glos GL6 9AN Lead Inspector Simon Massey Unannounced Inspection 3 4 & 5 September 2008 10:00 rd th th Stroud Court DS0000016591.V371465.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 Stroud Court DS0000016591.V371465.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. Stroud Court DS0000016591.V371465.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Stroud Court Address Longfords Minchinhampton Glos GL6 9AN 01453 834020 01453 837220 ann@stroudcourt.org 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) Stroud Court Community Trust Mrs Sharon Barnard Care Home 39 Category(ies) of Learning disability (39), Learning disability over registration, with number 65 years of age (1) of places Stroud Court DS0000016591.V371465.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. LD(E) Category for one named service user only Date of last inspection 19th February 2007 Brief Description of the Service: Stroud Court provides care for up to 39 adults with learning disabilities who have been diagnosed with an Autistic Spectrum disorder. Service users accommodated have high dependency and supervision needs. The home consists of seven separate units each with a dedicated staff team and a team leader. Two of the units, Rosemary Heights and Magnolia Heights are located in the main building, which also houses the central kitchen, activity rooms and offices. The other five units, Court View, Dobson House, Sycamore House, Gateway House and Westbank are all individual houses within walking distance of the main house. Also on site there is a day centre for Stroud Court residents and a swimming pool. All individual units have a domestic type self contained accommodation and all service users have single rooms. The home is set in extensive grounds and the site is within short driving distance of Nailsworth and Minchinhampton towns. The home provides own transport for accessing community facilities as it is not located on the main public transport route. A variety of local amenities including a bus station, post office, shops and banks can be found approximately a mile away in Nailsworth. Stroud Court DS0000016591.V371465.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 3 star. This means the people who use this service experience excellent quality outcomes. The judgements contained in this report have been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. This unannounced inspection took place over three days. The inspector met with the Registered Manager, various care staff and had contact and conversations with a number of service users. Records relating to staff training and recruitment, medication administration, health and safety and service user care planning were examined. An inspection of the environment of four of the seven domestic units was also undertaken. The inspector also had the opportunity to attend the Stroud Court Annual General meeting. A number of surveys were also circulated to staff, parents and outside professionals. What the service does well: What has improved since the last inspection? Improvements have been made in the variety of activities that can be accessed both in the home and in the community. The individual houses have been given more responsibility for menu planning, shopping and food preparation. An improved induction-training package is now in place for all new staff. There has been a further decrease in the occurrence of incidents that have required physical intervention from care staff. Health action plans are now being developed for all service users. Stroud Court DS0000016591.V371465.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Stroud Court DS0000016591.V371465.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 Stroud Court DS0000016591.V371465.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The admission procedure ensures that people’s needs and aspirations are assessed prior to prospective residents moving into the home. EVIDENCE: The service has had no admissions during the previous twelve months and has maintained an occupancy of 35, though the service is actually registered for 39. There are no plans at present to fill these vacancies. A previous inspection have shown that there is a thorough admissions and assessment process in place for all perspective service users. The Provider has produced a Statement of Purpose in the form of a prospectus and also a Service User Guide, a copy of which is placed on each individual’s file. These documents are periodically reviewed and the home have stated to the Commission that will be undertaken shortly. These documents combine the use of text, photographs and symbols. Stroud Court DS0000016591.V371465.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6,7 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Detailed care plans ensure that the service user’s needs are documented and guidance is available to staff. The home takes action to encourage service users to make choices and supports them to take appropriate risks. EVIDENCE: A sample of the care plans were examined in a number of the residential units and it was seen that the improvements identified at the previous inspection have been maintained. All plans seen had been appropriately reviewed and changes recorded. Each house keeps daily diaries for service users which can be taken to different activities where day staff can write information if required. All plans are reviewed every six months, which is generally a paperwork exercise unless circumstances dictate otherwise and then there is a full annual review of the care plan involving all interested parties. There was evidence that service users who are able are encouraged to contribute to their plans. Stroud Court DS0000016591.V371465.R01.S.doc Version 5.2 Page 10 The main individual files contain records of the care plans, health records, weight charts, and correspondence. Those seen were up to date and well organised. All care plans seen were detailed and up to date but in some cases did not fully reflect some of the medium and long terms goals that have been identified by the staff. Some service users who are being supported to learn greater independence skills, both in the home and in the community did not always have this work fully reflected in their care plans. Staff gave examples of skills they were encouraging such as cooking and menu planning but some of the units are more pro-active than others in encouraging service user involvement in daily living chores and tasks. Staff in two of the houses explained how they involved service user in clearing up after meals but that they thought it was too risky for them to be involved in the kitchen whilst cooking was being undertaken. There is scope for more flexibility in this approach. It is possible that the person centred planning format could be used more flexibly in some cases to develop plans that would better inform practice for some service users. It was observed that the greater ownership and responsibility for care plans, which has been passed to the individual units following changes in the management arrangements, has been received positively by the care staff. The majority of staff spoken with demonstrated a good knowledge of the individual care plans, and any additional guidance, that was in place with regards to the delivery of care and support. Overall the inspector observed that there have been improvements in the link between documentation and practice but there is scope for more specific short and medium terms goals to be identified and recorded. Whilst there were some minor inconsistencies in the quality of the daily recording, all serious incidents were correctly and accurately recorded and appropriate audit trails were in place. Notifications received by the Commission have been also detailed and promptly provided. These also provide evidence that the service evaluates situations professionally to see how, or what, progress can be made. The risk management systems used were generally seen as excellent, with an emphasis on enabling and maintaining activities wherever possible. Recording was seen with regards to one person in the use of a “best interests” meeting. This was a good example of encouraging choice and decision making for the individual concerned. Consideration has also been given to the involvement of an advocate and whether the Mental Capacity Act has relevance to the issues. The service has a Total Communication co-ordinator and since the previous inspection the base for this department has moved into the main building from a different part of the site. This has been a positive move according to those involved, and staff were positive about the role of this department within the Stroud Court DS0000016591.V371465.R01.S.doc Version 5.2 Page 11 service. A “Speak for Yourself” group has continued to meet and empower and encourage service users to make decisions and express opinions. There was evidence throughout the different units of pictures and symbols being used to improve understanding and maximise the communication between service users and staff. Two service users were observed updating picture and symbol boards with information that was relevant to them. Staff also explained how they tried to evaluate what worked best for each individual, so as to avoid the use of pictures or symbols when these were not effective. Stroud Court DS0000016591.V371465.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): 12,13,15,16 & 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users are supported to identify and pursue their interests and have a lifestyle that meets their needs. They are able to access the local community with support. Support from the home enables service users to maintain positive relations with friends and relatives EVIDENCE: The service continues to provide and support a wide range of activities for service users to choose from, both on site and in the community. Music therapy, arts and crafts, gardening, kitchen work, a swimming pool and a trampoline are all available on site. Numerous college courses are also being undertaken and there are also regular walking trips and shopping excursions. The inspector was informed that 70 of the service users undertook some form of college course in the previous academic year. Stroud Court DS0000016591.V371465.R01.S.doc Version 5.2 Page 13 During the inspection visit numerous activities were observed being organised and undertaken. Service users were observed participating willingly and enthusiastically and there were various opportunities for people to go out into the community. One person was observed declining an organised trip and this was dealt with sensitively and professionally by the staff, who recognised how the situation should be managed. Staff demonstrated good awareness of the need to keep to routines and fully inform service users of the plans for the day or the coming evening. One person whose plans for the evening had to be changed was observed being supported to alter their visual planner. The service has a designated activities co-ordinator who explained how they plan and offer choices over activities with the involvement of the care staff and the individual service users. The service provides a number of vehicles for use by the houses to support outings and activities. The individual houses have been given more control over their food menus and shopping. This was seen as a very positive change by staff and service users. Care staff explained how individual diets and preferences were catered for and there was information and instructions available in the homes for staff to follow. Special dietary needs were also recorded within the individual files. Staff interviewed stated that sufficient budgets were provided and people were generally very positive about the quantity and quality of food provided. Several staff explained how healthy eating is promoted, whilst respecting choice and individual preference. Detailed recording was seen of the menus provided. Food was correctly stored and labelled, with one minor exception, and there were ample stocks of fresh and packaged food in the houses. Accurate records were kept of fridge and freezer temperatures. Stroud Court DS0000016591.V371465.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Health needs are closely monitored and appropriate professional input provided to meet the needs of the service users, and provide advice and guidance for the staff team. The completion of health action plans will further improve outcomes for service users. Satisfactory arrangements are in place for the handling and administration of medication. EVIDENCE: A sample of medication storage and administration was examined in four of the houses. These found that medications were correctly stored and records accurate and up to date. Medication is checked in centrally before being delivered to the individual households. It is recommended that consideration is given as to whether the individual houses should book their medication in. At present quantities can be calculated by using the marr charts. Evidence was seen of medication being reviewed and changes correctly recorded. In the houses visited none of the service users self-medicate at present. It is recommended it is considered whether it is possible for some of the more independent service users can be risk assessed to move towards selfmedication. This would obviously need to be done on a structured and monitored basis. Stroud Court DS0000016591.V371465.R01.S.doc Version 5.2 Page 15 All service users are currently having Health Action Plans completed. This work is being primarily undertaken by a designated group of care staff. The health records in the main individual files contain sections on appointments, optician reports, chiropody appointments, nurse visits and dental checks. These show that service users are supported to attend appointments and that good monitoring of health needs is undertaken by the staff. Feedback from relatives was positive about the meeting of health needs and one parent commented upon the “excellent care and communication” provided during a period of hospitalisation. Stroud Court DS0000016591.V371465.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home provides a safe environment for service users in which they are respected and treated with dignity. The home has satisfactory arrangements and procedures in place for the protection of service users. EVIDENCE: Staff are provided with accredited training in the managing of challenging behaviours and updates are also provided for this training. Staff also complete training in Adult Protection during the induction period. The registered manager has also undertaken enhanced training in Adult Protection. There are processes in place for the monitoring of behaviours using a “traffic light system” with information being collated on a daily basis when necessary. Staff demonstrated a good understanding of this system and records seen were accurate and up to date. Senior care staff commented that the reduction in incidents of challenging or aggressive behaviours had continued to decrease due to improved training, better recruitment procedures and greater awareness of the staff team as a whole in relation to the field of autism. Training has also been provided in relation to the Mental Capacity Act. Staff are also required to complete training in adult protection issues during their induction. Stroud Court DS0000016591.V371465.R01.S.doc Version 5.2 Page 17 The home has a communication co-ordinator who has set up a self-advocacy group for the service users and staff gave examples of how this had benefited some service users. Examples were also given of how improved communication helped staff to support service users to make choices and be involved in decision making in issues within the individual houses, and also in respect of their care and support. Staff spoken with were clear about how they would raise a concern or make a complaint. Responses from surveys supplied to relatives also confirmed that they were aware of how to make complaints and that these would be listened to and acted upon by the management of the service. The service promotes an open culture and has reported or discussed any issues of concern with outside agencies when this has been appropriate. Staff and relatives said they felt confident approaching any member of the management team Stroud Court DS0000016591.V371465.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are provided with an environment that is comfortable and homely. Service users are supported and encouraged to personalise their living space according to personal taste and needs. Good planning and organising of maintenance and repairs ensures that service users are provided with a safe environment. EVIDENCE: The houses visited were all clean and hygienic and also homely and comfortable. Individual rooms were personalised and there was also artwork completed by service users on display in some areas. Two staff were observed entering bedrooms without first knocking, though these rooms were empty at the time. Two service users spoken with said that their privacy was respected and that staff always knocked on their doors before coming in. Staff questioned were aware of the need to ask permission before entering bedrooms. Stroud Court DS0000016591.V371465.R01.S.doc Version 5.2 Page 19 The Provider is still in the process of developing the plans for the redevelopment of much of the accommodation. This is a lengthy process, mainly due to the scale of the plans being developed. As part of this visit the Inspector attended the annual meeting for Trustees and relatives where an updated report was given on the progress of the plans. It is intended that the new accommodation will provide suitable accommodation to better meet current needs and also in anticipation of changing needs in years to come. The service has to strike a balance between maintenance and investment in the current accommodation and the anticipation that some large scale changes will be made to the site. Whilst a detailed inspection was not completed of the entire environment during this visit, the houses visited were all well maintained and generally decorated to a good standard. Several service users spoken with expressed satisfaction with their accommodation and their bedrooms in particular. Stroud Court DS0000016591.V371465.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Care is provided by a skilled and competent staff team, promoting service users’ safety and wellbeing. A good recruitment and selection framework helps to safeguard the people living in the home. EVIDENCE: Staff rotas showed that sufficient cover is provided and staff interviewed stated that staffing levels are correctly maintained and that the right numbers are generally provided. Also additional staffing requests for specific activities or trips can be organised and supported. Records within the home show that there has been a decrease in staff sickness over the previous two years and also that staff turnover has also reduced. Several staff commented that the decrease in turnover has had a beneficial effect generally on the quality and continuity of care provided. Staff were very positive about the training that is provided and supported, both in terms of the variety and appropriateness to their roles, but also in terms of the quality. Several staff commented that the training provided them with the skills they need to deliver the care that is required. Stroud Court DS0000016591.V371465.R01.S.doc Version 5.2 Page 21 All new staff are expected to undertake the home’s Induction training and a sample of the new written format was provided. This is an excellent and comprehensive document that covers all aspects of the work undertaken. It ensures that competencies are signed off when they are met and provides a record of the initial training undertaken by all staff. Staff who had completed the induction commented that it had been a very positive experience and prepared them thoroughly for their role. Senior staff and care staff said they thought that communication was generally very good within the service and that an “open culture” was being promoted which made for a positive working environment. Parents and relatives were also positive about the communication with the staff team. One commented “staff seem much better informed these days about everything that is going on.” Feedback form care staff supported the view that sufficient staffing levels are maintained and that requests for additional cover to support organised activities or outings are positively received by the management. Staff spoken to commented upon good levels of support and regular supervision. They were also very positive about the increase the amount of time some service users spend out in the community and the general level of activities and leisure opportunities that are provided. Staff were also very positive about the team working and communication, both within the team and also across the service as a whole. Staff said they found managers approachable and supportive. The inspector observed various examples of good practice with care staff interacting and relating to service users in a respectful and professional manner. Service users able to comment were very positive about the staff. Staff were observed responding to some anxious behaviour from one service user, relating to some confusion over a visit to relatives. This was dealt with calmly and the matter resolved professionally. In general staff appeared motivated and positive about their work and demonstrated good awareness of the needs of the service users and the skills required by themselves as carers. A sample of staffing records were examined and these were seen as being in order with all necessary pre-employment checks being completed and documented. The concerns that were identified at the previous inspection have been addressed. Feedback provided to the inspector from relatives was very positive about the staff team. Many commented upon the “dedicated staff” and the excellent communication and information they are provided with. Others comments included that staff, “are always helpful and caring”, “I am very happy with the level of care my son receives”, “it is one of the best care homes in the country”. One parent stated that “the staff are wonderful and I have no real criticism….my son has improved immensely since moving there”. Stroud Court DS0000016591.V371465.R01.S.doc Version 5.2 Page 22 18 surveys were returned from relatives and all contained positive comments with regards to the staff teams at the home. Stroud Court DS0000016591.V371465.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): Standards 37, 39 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from a home that is well managed and organised and committed to providing high quality care and support. Systems are in place that help to monitor and improve the quality of the service. EVIDENCE: Senior carers and care staff said they found the manger approachable and supportive, and they are able to communicate by visiting the office and by via email using the internal intranet. The manager, who is supervised by the Executive Director, supervises the senior staff. This is presently done primarily on an informal basis with regular team meetings and contact, and senior staff were very positive about this arrangement. It is recommended that consideration being given as to whether these staff should receive more formal recorded supervision as part of their personal development, and also annual appraisals. Stroud Court DS0000016591.V371465.R01.S.doc Version 5.2 Page 24 The registered manager liaises with the day-care staff and the senior managers. These staff are supervised by the Director. The Director also occasionally attends care staff and senior staff meetings. Staff said they found all the management approachable, supportive and responsive to concerns or issues that are raised. Changes have been made to the management structure, which has resulted in giving more autonomy and responsibility to the individual Team Leaders in each house. This has also resulted in a system where the Senior Carers will perform audits on other units. Team leaders were positive about this process and stated that they found this supportive and informative. All fire safety checks and maintenance had been completed and recorded and the service has a comprehensive fire risk assessment in place that is reviewed annually. There is an ongoing programme of fire safety training in place with senior carers undertaking additional training. All portable electrical appliance testing has been completed and also the gas safety certificate was up to date and in place. The oil central heating system has also been regularly tested and certificated. The home has a facilities manager who co-ordinates maintenance, equipment servicing and health and safety issues. This appears to be a very professionally run department with excellent auditing and monitoring systems and detailed recording in place. The service maintains a total of 10 vehicles for use by the staff and service users. These are all checked on a weekly basis. Staff have to undergo an assessment before they are permitted to drive the service’s vehicles and there are also risk assessments relating to any service users who have particular needs in relation to using transport. Trustees of the service undertake regular visits to the home and reports are submitted as a result of these. As mentioned previously senior care workers undertake audits of other houses within the service and provide feedback on visits. Stroud Court is accredited to the National Autistic Society and copy of the latest report was supplied to the inspector as part of this inspection process. Feedback from relatives was very positive about the management of the home and several commented upon the steady and consistent improvements that have occurred over the past few years. People were positive about communication and information sharing and comments were also made about the direction and leadership that is provided by the senior management team. Stroud Court DS0000016591.V371465.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 X 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 4 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 4 33 X 34 3 35 4 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 x LIFESTYLES Standard No Score 11 X 12 4 13 4 14 X 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 4 x Stroud Court DS0000016591.V371465.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 Refer to Standard YA20 YA37 Good Practice Recommendations Consideration should be given to whether self medication has been fully explored for some service users. The home should consider providing regular formal supervision and appraisals for senior staff Stroud Court DS0000016591.V371465.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA 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 Stroud Court DS0000016591.V371465.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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