Care Home: Summerson House

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What the care home does well Before moving here people have the opportunity to visit, stay over and get to know other service users and staff. The staff are good at identifying what people need and in meeting these needs. They get on well with the people who live here. The staff make sure that service users have access to health care and community services and facilities, such as shops, libraries, cafes, and so on. They will also speak up for service users where necessary. There is a minibus, paid for by the people living here, which is used to help them to get out and about. Care planning is clear and to the point and service users` needs are clearly documented. This guides staff`s work with the people who live here. New staff are also told about people`s needs when they start working here. This is so they can provide the care that is needed. The building is easy for people who are physically frail or disabled to get around. There are adaptations, such as hoists and special beds to help people to use the bath, to get into and out of bed safely, and so on. Recruitment checks include the taking up of references and Criminal Records checks. These help to ensure safe recruitment practices are in place, although evidence of these checks is not kept here. What has improved since the last inspection? What the care home could do better: CARE HOME ADULTS 18-65 Summerson House 29-31 Stone Street Windy Nook Gateshead Tyne & Wear NE10 9RY Lead Inspector Mr Lee Bennett Unannounced Inspection 10 December 2007 and 3 January 2008 11:00 th rd Summerson House DS0000007424.V351358.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 Summerson House DS0000007424.V351358.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. Summerson House DS0000007424.V351358.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Summerson House Address 29-31 Stone Street Windy Nook Gateshead Tyne & Wear NE10 9RY 0191 469 9611 P/F 0191 469 9611 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) www.c-i-c.co.uk. Community Integrated Care Cheryl Jones Care Home 6 Category(ies) of Learning disability (6), Physical disability (5) registration, with number of places Summerson House DS0000007424.V351358.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 8th November 2006 Brief Description of the Service: Summerson House is care home, providing personal care for up to six people with a learning disability. Nursing care is not provided, but district learning disability and psychiatric nursing services can be arranged where necessary. It is a purpose built bungalow style care home, with level access throughout. There is a large enclosed garden to the side and rear of the home, which includes a smaller paved area. The home is situated in a quiet residential area near to local public transport links and a range of local facilities, including a doctors surgery, shops, pubs and places of worship. The shopping centre and community facilities at Felling are a short drive away. The range of fees charged at the service are £1,385.35 per week (2006 / 07). Additional charges are made for the purchase and use of a mini bus. Summerson House DS0000007424.V351358.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. We rate services in the following way: 3 2 1 0 stars = ‘excellent. stars = ‘good’. star = ‘adequate. stars = ‘poor’. Before the visit: We looked at: • Information we have received since the last visit in July 2006. • How the service dealt with any complaints & concerns since the last visit. • Any changes to how the home is run. • The manager’s view of how well they care for people. • The views of people who use the service & their relatives, staff & other professionals. The Visit: An unannounced visit was made on the 10th December 2007. An announced visit was made on 3rd January 2008. During the visit we: • Talked with people who use the service, staff and the manager. • Observed life in the home. • Looked at information about the people who use the service & how well their needs are met. • Looked at other records, which must be kept. • Checked that staff had the knowledge, skills & training to meet the needs of the people they care for. • Looked around parts of the building to make sure it was clean, safe & comfortable. • Checked what improvements had been made since the last visit. We told the manager what we had found. What the service does well: Before moving here people have the opportunity to visit, stay over and get to know other service users and staff. The staff are good at identifying what people need and in meeting these needs. They get on well with the people who live here. Summerson House DS0000007424.V351358.R01.S.doc Version 5.2 Page 6 The staff make sure that service users have access to health care and community services and facilities, such as shops, libraries, cafes, and so on. They will also speak up for service users where necessary. There is a minibus, paid for by the people living here, which is used to help them to get out and about. Care planning is clear and to the point and service users’ needs are clearly documented. This guides staff’s work with the people who live here. New staff are also told about people’s needs when they start working here. This is so they can provide the care that is needed. The building is easy for people who are physically frail or disabled to get around. There are adaptations, such as hoists and special beds to help people to use the bath, to get into and out of bed safely, and so on. Recruitment checks include the taking up of references and Criminal Records checks. These help to ensure safe recruitment practices are in place, although evidence of these checks is not kept here. What has improved since the last inspection? There is a relaxed atmosphere in the home, and the manager and her deputy work well as a management team. Quality checks are in place to ensure the service continues to improve. The last inspection identified several requirements and recommendations. Those dealt with include: • • More detailed information given to new staff on how to prevent and deal with difficult situations, including details about when and how restraint is used. The introduction of regular safety and quality checks. A person independent of the home has been found to help with decisions about money and to try and help open up individual bank accounts for the people living here. What they could do better: The home provides a good level of care for service users, but there are some areas where improvements could be made. These include: • The need to completely review all guidelines, care plans, risk assessments, and other records in connection with the way people are restrained (and how the need for restraint can be avoided). Summerson House DS0000007424.V351358.R01.S.doc Version 5.2 Page 7 • Medicine, such as creams, need to be stored separately from other forms, such as tablets, to ensure good hygiene. 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. Summerson House DS0000007424.V351358.R01.S.doc Version 5.2 Page 8 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 Summerson House DS0000007424.V351358.R01.S.doc Version 5.2 Page 9 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): 2 and 3. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective users’ individual needs and aspirations are assessed in a way that meets service users diverse needs and wishes to a good level. EVIDENCE: When a person needs help with their care, for example when they are a person who needs help getting around, or with getting dressed, eating their food, and so on, they are entitled to an assessment by social services (even if they can afford to pay for care themselves). This is to identify what their needs are and to help then to find services that can help to meet these needs. Therefore, before moving here a person will have received an assessment. If they choose to come here, the manager will get a copy of the assessment document so they are clear what help the person requires, and to decide if they can provide the necessary support. This is the case for all of the people living here. There have been no new service users admitted here recently. However, the care experienced by a sample of service users was ‘case tracked’. Of the case files examined it was evident that their needs were assessed before coming here, and have also been re-assessed (both by social services and C-I-C staff) Summerson House DS0000007424.V351358.R01.S.doc Version 5.2 Page 10 after coming here. This is to ensure that the information held is up to date and staff are clear about what help and support each person needs. On the whole, the information detailed in the assessments mirror the needs observed by the inspector. The needs of each service user are detailed within their personal case files, and they also detail the action taken to meet these needs and progress made. As well as having their level of need looked at, the people moving here (or those making decisions on their behalf) will want to be confident that the staff, the home and the facilities here are fully suitable. To this end staff receive relevant training. The staff come from a range of work and personal backgrounds, that can also contribute to the way they communicate and work with the people living here. Staff are also now beginning to receive (or are planned to attend) more training and guidance relevant to service users specific, diverse and specialist needs. These include needs relating to their health, epilepsy, personal care, challenging behaviours and medication. Further advice is available from specialists within the Social Services part of the local council (currently called Community Based Services) and the Community Learning Disability Team (which is part of the NHS and includes health workers such as nurses, psychologists and psychiatric doctors). The home has adaptations to help people get around, to use the bathing facilities and to get in and out of bed safely. Summerson House DS0000007424.V351358.R01.S.doc Version 5.2 Page 11 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 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. All of the people living here have clear care plans and risk assessments in place. Effective care planning can offer guidance to care staff regarding care practice and ensure consistency where necessary. Good risk assessment can help promote independences, whilst maintaining safety. Important decisions taken on behalf of service users (around money) means that their best interests may not always be considered first. EVIDENCE: The communications skills and needs of the people living here means that staff often have to interpret their choices, and need to understand the meaning of their behaviour, gestures and noises. This is the case when developing care plans and in responding to day to day situations. Staff can clearly demonstrate their ability by assisting service users to communicate, and were Summerson House DS0000007424.V351358.R01.S.doc Version 5.2 Page 12 also observed to discuss and explain routines and activities with service users, irrespective of their communication needs. People are asked and allowed to make decisions affecting day to day choices and about the activities they participate in. They are also encouraged to undertake, help, or to participate as observers with chores in the home. Staff will also help service users to communicate with other people involved in their care, such as doctors, dentists, social workers, nurses, and so on. Staff are mindful of how service users feel from day to day, and will also tailor what is offered on this basis. Sometimes people using the service need help with important decisions about money. For example, as has been reported following the last four inspections, an adapted ‘mini-bus’ type vehicle is available for service users living at the home. This is funded through their personal benefits income, and allows for them to access a range of community services and facilities. There are individual agreements drawn up between the service user and Community Integrated Care (C.I.C.) in the form of a contract. However, a representative of C.I.C. has signed this agreement on behalf of the service users as well as on behalf of C.I.C. This appears to present a conflict of interest. An advocate has now been arranged to look at this arrangement and to help in future decisions that are made, and this work is currently ongoing. To help guide the care offered to the people living here, a care plan file is compiled. Each service user here has had one developed. These are all written up, evaluated and reviewed by the manager, her deputy and a ‘key worker’; a member of staff who works with a named service user and takes a lead on the planning and delivery of care. The care files contain detailed information on each person’s needs, and how these are met, and has been built up over several years. Closely linked to care planning arrangements are risk assessments. Again, these have been developed by the manager, her deputy and a key worker. Areas of risk are then documented within each service users’ care filte. This includes assessments about activities out of the home, behaviours that may challenge the service, and the use of equipment. This helps staff to make proper arrangements and guidance which means that people are able to access community facilities without being placed at undue risk of harm. A model is used, whereby each risk area is identified, who or what may be harmed is noted, current and additional control measures are documented, and this is then reviewed. Summerson House DS0000007424.V351358.R01.S.doc Version 5.2 Page 13 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 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are assisted, to a good degree, to lead active and fulfilling lifestyles by having a regular community presence, by accessing a range of community facilities and by keeping in touch with family and friends. This will assist in them leading a full and enjoyable life. People’s rights are generally well protected, but money matters and the use of restraint does not always put these rights first. Service users are offered and receive a menu and diet that meets their preferences and health needs. This can contribute to their general health and wellbeing. Summerson House DS0000007424.V351358.R01.S.doc Version 5.2 Page 14 EVIDENCE: On the two days of the inspection, the people here were supported by staff, in activities around the home. The weather on both days was very poor, with snow, sleet and rain. Service users are also supported to have trips out, to use a sensory room, and to go on holiday. For all service users, their individual choices are recorded, and the activities undertaken reflect these choices, their needs and risks. A minibus, with trained drivers, is available to help people get to community facilities. As well as going out and about, contact with friends and relatives can affect the quality of life enjoyed by people. Although contact with relatives varies for the people living here, due to their individual circumstances, staff in the home will assist service users to ‘keep in touch’ by sending cards and making phone calls. Service users also attend a range of activities, such as going out for meals and to the local pub, that allows them to interact with people outside of their immediate home environment. Service users don’t only have rights to keep family contact and to lead a varied and fulfilling lifestyle. They also retain rights around how they are helped, and what staff do when they challenge them, become agitated, or put themselves at risk of harm. All staff must remember this when they use methods of restraint, which need to be used only when necessary, in a safe way and in a manner consistent with the law. This is also true of the way decisions are made around people’s money and how it is used. The organisation as a whole needs to develop a more ‘rights’ led approach to help people make decisions about their money and what happens to it. This should be open to scrutiny and support from people who don’t work for CIC (but who act on behalf of the service user) to check. Meals are normally taken within the two separate dining rooms. Service users have a range of dietary needs, which are outlined within their care plans. There is a record kept of the meals planned and provided. Some people living here need help with eating their meals. Staffs’ practice reflects the guidance and risk assessments provided, for example to prevent service users from choking and eating too fast. Summerson House DS0000007424.V351358.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users personal healthcare needs are well supported by good systems that ensure choice, privacy and dignity is respected and that their health and welfare is maintained. EVIDENCE: The service users living at Summerson House have their personal and healthcare needs outlined within their case files. Their needs are supported and met, where appropriate, in private, and they are encouraged to cater for their own needs where possible. Specialist support and aids (such as manual handling hoists, ceiling tracking and adapted baths) have been sought and obtained where necessary, and multi-disciplinary input (for example from the Occupational Therapist and Speech and Language Therapist) are made available. As well as making sure appropriate equipment is in place, the registered manager has helped service users in accessing health care treatment. The Summerson House DS0000007424.V351358.R01.S.doc Version 5.2 Page 16 result of health care visits and routine monitoring is recorded within each service users’ care file. The help and advice of a psychiatrist, psychologist and community learning disability nurse has been sought for those service users who, on occasions, become agitated and aggressive. Because of this they may need to be physically supported and restrained by staff. This is particularly the case should they put themselves or others at risk of harm. On the whole, staff now record such incidents. The help of other healthcare professionals has been sought to look at the incidents, analyse these and then recommend alternative courses of action. This is to help reduce the likelihood of incidents occurring, and should they happen, reduce their severity. Linked to these health and personal care arrangements, is the support given with medication. Due to their levels of need, service users are not able to administer their own medicines, and designated staff will help in this area. Several staff at the home have had medication administration training (the safer handling of medication course). This has been added to by in house training on this topic. The medicines themselves have been placed in locked storage to keep them safe. However, internal and external medicines are not stored separately from one another which does not ensure good hygiene practice. Once given out, staff write down who has had what medicine on printed administration records. A sample signature list is maintained to identify, which staff were responsible for each medication administration. A medication administration was observed, and good hygiene practices were followed the person concerned. An audit of the medications used by service users who were ‘case tracked’ was also carried out by the inspector, but this could not be finished due to missing or incomplete records. One set of medicine administration records had gone missing after they were sent with a service user with them to hospital and then lost there. Summerson House DS0000007424.V351358.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Clear systems support people using the service to express their views and ensure they are listened to and acted upon. They also help ensure that service users are protected from abuse, neglect and self-harm. EVIDENCE: There have been no complaints reported within the past twelve months. As noted above, service users have varying communication needs, which make it difficult for them to say what they think about the service they receive. Staff therefore have to be mindful of service users’ behaviour as a means to gauge their feelings. Staff have, in the past, received training from the local Adult Protection Coordinator, which will help to explain the role of adult protection, and to offer guidance to staff. The care provider (C.I.C.) has its own procedures as well. Both the home’s own and the local authorities adult protection procedures are available in the home and have been used where necessary. The current procedure used by C.I.C. when an allegation of abuse against a member of staff is made, is for the direct manager to carry out the investigation, rather than a manager of a different service who may be able to remain more impartial. Summerson House DS0000007424.V351358.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 and 30. 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 good, well maintained, homely, safe and clean accommodation. This can help promote a positive image for service users, and ensure they remain comfortable and safe. EVIDENCE: Summerson House is a purpose built bungalow, which provides level access throughout. Communal areas consist of a two lounge areas and a separate dining room in one end of the bungalow. There is also a conservatory area. Domestic style furnishings and fittings are provided, and adaptations, such as ceiling tracking, a hoist, grab rails and an adapted bath, have been installed. Bedrooms have been decorated and furnished in line with each service users’ personal tastes. Summerson House DS0000007424.V351358.R01.S.doc Version 5.2 Page 19 There were no observed hazards to health and safety. The home is clean and safe and odours are well controlled. Refurbishment and redecoration has taken place where this has been needed. Summerson House DS0000007424.V351358.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 and 35. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users are well supported by an effective and competent staff team which, ensures that service users are supported in a safe manner by staff who have an understanding of their needs. However, recruitment processes are not sufficiently to robust to ensure unsuitable candidates are not employed. EVIDENCE: Staffing levels are maintained to a level where there is never less than two care staff working at any one time during both the day and no fewer than two at night. Recent staff recruitment has led to a decreased use of agency workers, with a consequent increase in staffing consistency. Staff records and confirmation by the manager show that staff are only employed in the home once a range of background checks are carried out. These checks include the receipt of a Criminal Records Bureau (CRB) ‘disclosure’, two written references, and confirmation of physical fitness. This helps determine a candidates suitability to carry out their caring role, although Summerson House DS0000007424.V351358.R01.S.doc Version 5.2 Page 21 decision making processes around those staff with convictions are not transparent, as actual copies of disclosure documents, and other records of decisions made, are not made available for inspection prior to their destruction. Also, the job application does not prompt candidates to provide a full work history or to offer an explanation for gaps in their work record. For example, one completed application form that was examined had no dates listed in the employment history, and was only a partial record. These gaps were not explored at interview, or any written explanation sought. This would have helped ensure CIC staff had taken all reasonable steps to validate a potential staff member’s suitability to work here. Following their recruitment to the home, new staff receive an induction. This is where they are told about working here, the needs of those people they are to work with, and important safety aspects of their job. Further training then follows. Staff received an increasing range of training in 2006, but uptake was variable for 2007. Topic covered included those relevant to the needs of service users, health and safety, and to care in general. The manager keeps clear records of the training staff have received, which can assist in the planning of future training for the staff team. Twelve out of the seventeen non-management staff have a qualification in care. Further staff are to work to achieve this award. Summerson House DS0000007424.V351358.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from a well managed home, where the quality and health and safety matters are regularly checked. This can help ensure the service remains focused on their needs and aspirations and that people remain safe. EVIDENCE: The manager has undergone formal assessment by CSCI to ensure her fitness to manage a care home. She is qualified to NVQ level 3 in care, and has undertaken a course of study to attain an NVQ at level 4 in care and management. She is an NVQ assessor, and has also done a course in supervisory management. She has also attended recent training relevant to her post and the needs of service users, including: Summerson House DS0000007424.V351358.R01.S.doc Version 5.2 Page 23 • • • • Moving and handling. Control and Restraint. Home Office training on employing foreign workers. Discrimination Awareness. As well as ensuring her own knowledge and practice remains up to date, the registered manager undertakes a number of quality checks and audits to ensure the standard of care is up to current good practice levels. However, due to the communication needs of most of the service users living at the home, it is not always easy to gain a clear understanding of service users’ views. Service users’ observed preferences are then documented, and staff use their gestures, expressions and behaviour to judge what it is they are communicating and whether they are happy or not with various aspects of the service. Just as the quality of the care provided is checked, so are health and safety matters. Therefore regular checks on the building are carried out, water and fridge / freezer temperatures are monitored, and working practices that could present a risk are looked at. Safe ways of working (for instance by the use of lifting aids) have been introduced. At the time of the inspection there were no observed hazards in the home. Summerson House DS0000007424.V351358.R01.S.doc Version 5.2 Page 24 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 3 4 X 5 3 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 3 32 4 33 X 34 2 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 2 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 2 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 3 X X 3 X Summerson House DS0000007424.V351358.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? Yes 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 YA7 Regulation 12(3) and 13(6) Requirement The registered person must ensure that the decision-making and liability arrangements entered into on behalf of service users, in respect of the minibus, are subject to external scrutiny and agreement, and best serve service users financial interests. The previous action plan dates for this repeated requirement were 12/12/05 and 21/05/06. The registered person must, in consultation with the local Social Services Department, arrange for service users’ personal allowances and benefits to be paid direct to them and not via any bank account operated by C.I.C. The previous action plan date for this repeated requirement was 21/05/06. The registered person must review medication procedures in the home to: • Ensure that original records are not removed DS0000007424.V351358.R01.S.doc Timescale for action 23/04/08 2. YA7 20(1 and 2) 23/04/08 3. YA20 13(4) 23/03/08 Summerson House Version 5.2 Page 26 from the home. • Internal and external medicines are stored separately. • The use of homely remedies is reviewed with the GP. This is to make sure service users health needs are met. 4 YA34 19 This is a new requirement. Staff recruitment procedures must be reviewed to ensure: • Copies of Criminal Records Bureau Disclosures are retained until after inspection. • Decisions about the recruitment of staff with a criminal record are subject to clear and documented processes. • Job application forms prompt candidates to supply a full employment history, with and explanation for any gaps in that record. This is to make sure unsuitable people do not work here. This is a new requirement. 23/03/08 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 YA23 Good Practice Recommendations A full audit, review and update of all documentation, procedures, risk assessments and care plans relating to physical interventions must be carried out. This is to make sure staff are clear about what practices are and are not to DS0000007424.V351358.R01.S.doc Version 5.2 Page 27 Summerson House 2. YA35 be used, and in what circumstances, so that service users remain protected from the inappropriate use of restraint. The registered person ensure all care staff receive a minimum of five days paid training per year (pro rata for part time staff). This is a repeated recommendation. Summerson House DS0000007424.V351358.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR 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 Summerson House DS0000007424.V351358.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. 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