Care Home: The Crescent

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What the care home does well All the written feedback received from the relatives of one person who uses the service and a member of staff was extremely positive about the home. Comments included, `Modus has a very high standard of work practice` and `we are satisfied with the very high standard of care given to our loved one. We are happy and content with the Crescent`. We believe the home is particularly good at developing care plans that are person centred and focus on individual`s strengths and personal preferences. These documents celebrate the individual`s life experiences and set out in detail how people`s current requirements and aspirations are to be met through positive individualised support. The service actively supports people who use the service to be independent and involved in all areas of daily living in the home. This includes where appropriate, taking responsibility for shopping, planning meals, and meal preparation.Procedures regarding Safeguarding Adults are available to all staff working within the home who were fully aware what action should be taken if they witnessed or suspected abuse, including when an incident needed to be referred to the Local Authority as part of their Safeguarding protocols. The home demonstrated that it is very open and transparent when discussing incidents with external bodies such as the police, care managers, and the CSCI. The area manager demonstrated a sound understanding of the importance and purpose of having an effective quality assurance system, which uses the views of major stakeholders to improve practice. What has improved since the last inspection? The home has a good track record of recognising areas of weakness and always manages them well. All the requirements and good practice recommendations made in the homes previous inspection report have been met in full. Sufficient numbers of the current staff team have now up dated their basic food hygiene and infection control training. Recent improvements made to the homes quality assurance system now means the representatives of the people who use the service have far more opportunity to express their views about the home and influence its future development. The homes activities room has been provided with more sensory and art equipment and materials, which has enhanced the lives of the people who use the service. The deadlock fitted the toilet door nearest the side entrance has been replaced with a more suitable device that can be overridden by staff in the event of an emergency. The recently introduced care plan and risk assessment formats are better working documents. Finally, the exterior of the home has been recently been repainted. What the care home could do better: All the positive comments made above notwithstanding the area manager for the home acknowledges the service is not `perfect` and recognizes the importance of self assessment as a means of continually improving the standard of care provided: There are no requirements or good practice recommendations made in this report. CARE HOME ADULTS 18-65 The Crescent 63 The Crescent Belmont Sutton Surrey SM2 7BT Lead Inspector Lee Willis Unannounced Inspection 3 September 2008 11:30 rd The Crescent DS0000071234.V366312.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 The Crescent DS0000071234.V366312.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. The Crescent DS0000071234.V366312.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Crescent Address 63 The Crescent Belmont Sutton Surrey SM2 7BT 020 8642 5778 020 8642 5778 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.moduscare.com Modus Care Limited Post vacant Care Home 3 Category(ies) of Learning disability (3) registration, with number of places The Crescent DS0000071234.V366312.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: 2. Learning disability - Code LD The maximum number of service users who can be accommodated is: 3 17th April 2007 Date of last inspection Brief Description of the Service: 63 The Crescent offers accommodation and personal support for up to three younger adults with autistic spectrum disorders and behaviours that challenge. The home is owned and managed by Modus Care Limited. Fiona Wild has been the homes acting manager since March 2007. This large detached property is situated in a leafy suburb of Belmont in between the centres of Sutton and Cheam. The home is also within five minutes walk of a number of local convenience stores, farm shops, restaurants, and a train station with good links to central London and Sutton. Built over two-stories the premises consists of three single occupancy bedrooms, a main lounge, dining area, large kitchen, activity room, staff sleep-in room/office, laundry, three WC’s, a bathroom and shower facility. The garden at the rear of the property is extremely well maintained and accessible. The home has developed clear information to help people who use the service and their representatives to understand what facilities and services are provided. Modus currently charges £2,120.63 to £2,677.68 a week per placement. The Crescent DS0000071234.V366312.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 stars. This means the people who use the service experience excellent quality outcomes. From all the available evidence gathered during the inspection process it was evident the home has a substantial number of strengths and a sustained track record of delivering good quality care for the people who live at the Crescent. We spent 3 hours at the home and met all three of the people who currently live there, and a senior support worker in charge of the early shift. We also spoke at length to the homes area manager and informally interviewed two relatively new members of staff who were both on duty at the time of this visit. Finally, we looked at various records and documents, including the care plan for one individual who uses the service. One of our ‘have your say’ surveys was completed and returned to us by a member of staff. The acting manager of the home also completed and returned our Annual Quality Assurance Assessment (AQAA) as requested. This selfassessment document tells what the providers think they do well, what has improved since the homes last inspection, and what the manager thinks they could do ‘better’. What the service does well: All the written feedback received from the relatives of one person who uses the service and a member of staff was extremely positive about the home. Comments included, ‘Modus has a very high standard of work practice’ and ‘we are satisfied with the very high standard of care given to our loved one. We are happy and content with the Crescent’. We believe the home is particularly good at developing care plans that are person centred and focus on individual’s strengths and personal preferences. These documents celebrate the individual’s life experiences and set out in detail how people’s current requirements and aspirations are to be met through positive individualised support. The service actively supports people who use the service to be independent and involved in all areas of daily living in the home. This includes where appropriate, taking responsibility for shopping, planning meals, and meal preparation. Procedures regarding Safeguarding Adults are available to all staff working within the home who were fully aware what action should be taken if they The Crescent DS0000071234.V366312.R01.S.doc Version 5.2 Page 6 witnessed or suspected abuse, including when an incident needed to be referred to the Local Authority as part of their Safeguarding protocols. The home demonstrated that it is very open and transparent when discussing incidents with external bodies such as the police, care managers, and the CSCI. The area manager demonstrated a sound understanding of the importance and purpose of having an effective quality assurance system, which uses the views of major stakeholders to improve practice. What has improved since the last inspection? What they could do better: The Crescent DS0000071234.V366312.R01.S.doc Version 5.2 Page 7 All the positive comments made above notwithstanding the area manager for the home acknowledges the service is not ‘perfect’ and recognizes the importance of self assessment as a means of continually improving the standard of care provided: There are no requirements or good practice recommendations made in this report. 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. The Crescent DS0000071234.V366312.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 The Crescent DS0000071234.V366312.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): 1&2 People who use the service experience good quality outcomes in this area. We have made this judgement using arrange of evidence, including a visit to this service. People who use this service have good information about the home in order to make an informed decision about whether the service is right for them. EVIDENCE: The area manager told us the homes Statement of Purpose and Guide was last reviewed in July 2008 and up dated accordingly to reflect any changes in that have occurred in the past 12 months, including the appointment of a new acting manager. The home has not received any new referrals in the past year because it has no vacancies. The area manager told us the homes admission procedures remain unchanged and demonstrated a good understanding of what constituted ‘best’ practice regarding new referrals. The Crescent DS0000071234.V366312.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 & 9 People who use the service experience excellent quality outcomes in this area. We have made this judgement using arrange of evidence, including a visit to this service. The homes approach to care planning is person centred and focuses on individual’s unique strengths and personal preferences. The plans also set out in detail how people’s current requirements and aspirations will be met through positive individualised support. The service has a ‘can do’ attitude and risks are managed positively to help people using the service lead the life they want. Any limitations on freedom, choice, or facilities are always in the person’s best interests, agreed by all the relevant parties, fully documented, and reviewed on a regular basis. The Crescent DS0000071234.V366312.R01.S.doc Version 5.2 Page 11 EVIDENCE: The area manager told us care plans had been recently improved to make them better working documents. The one care plan examined was very person centred and easy to read. All the staff spoken with told us they liked the new care plan format and felt it was far easier to use than the previous version. The one care plan examined in depth had been reviewed twice in the past twelve months with the service user, their relative, care manager, and keyworker. It was also clear from comments made by the relatives in the homes own quality assurance survey that Modus continue to encourage families to take an active role in their care planning process. In addition, to these formal reviews keyworkers are expected to review the care plans for the people they are designated on a monthly basis. This ensures care plans are continually up dated to reflect any changes in a persons needs and aspirations, for which the service is commended. A lot of information about who is going to be working on each shift, what meals are going to be served, and what activities and domestic chores people should be participating in each day is conspicuously displayed throughout the home on various notice boards in bedrooms, the kitchen, and the office. This information is available in easy to read formats that include all manner of coloured symbols and diagrams to enable the people who use the service to understand them. The area manager told us Modus had recently developed a new risk assessment format, which the home was in the process of introducing. The care plan examined contained detailed guidance for staff to follow in order to manage various identified risks. All the staff spoken with demonstrated a good understanding of the homes risk assessment procedures. The Crescent DS0000071234.V366312.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 People who use the service experience excellent quality outcomes in this area. We have made this judgement using arrange of evidence, including a visit to this service. The social, leisure, and recreational activities the people who use the service have the chance to participate in each day, both at home and in the wider community, remains varied and interesting. Dietary needs and preferences are well catered for ensuring the people who use the service are provided with daily variation and choice. EVIDENCE: On arrival a member of staff was observed supporting one service user do some artwork in the main lounge. Later that morning another member of staff was observed helping a service user make dessert in the kitchen. In the afternoon all three of the people who use the service went to a local park with staff. All the aforementioned activities were reflected on various weekly The Crescent DS0000071234.V366312.R01.S.doc Version 5.2 Page 13 schedules displayed throughout the home and in the one care plan we examined in depth. As recommended in the homes last report the ground floor activities/art room has been supplied with a greater variety of sensory and craft equipment and materials. The home has its own vehicle and 50 of the current staff team have been deemed fit by Modus to drive it. The area manager told us that one person who uses the service had already been on holiday this year with their family and that arrangements had been made for all three of the service users to go on holiday together next month. During a tour of the premises a lot of photographs and pictures drawn by the people who use the service were noted hung on the walls in most communal areas. The home still provides the relatives of the people who use the service with a monthly newsletter informing them about all the activities their loved ones have participated in. Keyworkers are responsible for arranging social leave visits for the service users and keeping their families informed about their loved ones life’s. Comments made by staff and relatives would suggest the service is particularly good at this. A member of staff was observed cooking lunch for the people who use the service that matched the meal displayed on that days published menu. The meal looked and smelt very appetizing. Care plans contain detailed information about service users food and drink preferences, as well as their dislikes. The area manager told us one service user who liked sausage rolls was supported to shop for this item of food each week and then cook it with staff. The kitchen door remained open throughout the visit and the area manager told us the one service user who was capable of making their own drinks with staff support was encouraged to do so as and when they chose. The Crescent DS0000071234.V366312.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 People who use the service experience good quality outcomes in this area. We have made this judgement using arrange of evidence, including a visit to this service. Suitably robust arrangements are in place to ensure the people who use the service receive personal support in the way they prefer and require, and that their unique physical and emotional health care needs are continually recognised and met. Policies and procedures for handling medication are sufficiently robust to keep the people who use the service safe. EVIDENCE: The one care plan examined set out in detail how the home intended to meet service users health care needs. Detailed records of all the accidents involving service users and staff are appropriately maintained. Three minor accidents have occurred since the home was last inspected in April 2007, none of which resulted in any one being admitted to casualty and sustaining any major injuries. The Crescent DS0000071234.V366312.R01.S.doc Version 5.2 Page 15 No recording errors were noted on medication administration sheets sampled at random. All the medication held by the home on service users behalves is securely stored away in the office. The area manager told us the home does not currently handle any as required or controlled drugs. Staff are responsible for carrying out weekly medication audits and maintaining monitoring records. The Crescent DS0000071234.V366312.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 People who use the service experience excellent quality outcomes in this area. We have made this judgement using arrange of evidence, including a visit to this service. The homes arrangements for dealing with concerns and complaints are sufficiently robust to ensure the representatives of the people who use the service feel their views will be listened to and acted upon. The people who use the service are protected from abuse and neglect because the home has excellent procedures in place that are understood by the staff. EVIDENCE: The homes complaints log revealed that no concerns have been raised about its operation since it was last inspected. The area manager told us any complaints made would always be taken seriously and dealt with in a timely manner. There has been one allegation of abuse disclosed about a member of staff in the past year and a half. The allegation of physical abuse, which was substantiated following an investigation, was handled extremely well by the homes area manager in a very prompt and professional manner. In line with best practice guidelines the member of staff was suspended from their duties as a neutral move, immediately referred to the protection of vulnerable adults register for provisional inclusion, and all the relevant external agencies notified without delay, including the police, the local authorities safeguarding team and the CSCI. The Crescent DS0000071234.V366312.R01.S.doc Version 5.2 Page 17 The two relatively new members of staff informally interviewed during this visit told us they had received recognising, preventing and reporting abuse training as part of their induction and both demonstrated a good understanding of what constituted abuse and who they should notify if they witnessed or suspected it within the home. The area manager told us a representative of Modus care who does not work in the home is the appointee for the people who use the service. Finances are audited on a regular basis. The Crescent DS0000071234.V366312.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 People who use the service experience good quality outcomes in this area. We have made this judgement using arrange of evidence, including a visit to this service. The spacious layout and good quality interior design of the premises ensures the people who use the service live in a very homely and comfortable environment. The homes arrangements for controlling infection are sufficiently robust to ensure the people who use the service also live in a very clean and safe environment. EVIDENCE: The area manager told us there had been no changes made to the physical layout or design of the homes interior since it was last inspected, although the exterior had been recently repainted. The Crescent DS0000071234.V366312.R01.S.doc Version 5.2 Page 19 As recommended in the homes last report a more suitable locking device that can be overridden by staff in the event of an emergency has been fitted to the ground floor toilet nearest the side entrance. Also, the acting manager has resealed the first floor bath. The large garden at the rear of the property looks well maintained and staff meet told us the people who use the service make good use of it. The homes washing machine is capable of cleaning laundry at appropriate temperatures in accordance with infection control standards. Ample supplies of latex gloves were noted during a tour of the premises. The Crescent DS0000071234.V366312.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, 33, 34, 35 & 36 People who use the service experience good quality outcomes in this area. We have made this judgement using arrange of evidence, including a visit to this service. People who use the service have safe and appropriate support as there are enough competent, qualified staff on duty at all times. People’s needs are also met because staff get the right training, supervision and support they need from the management team to carry out their duties effectively. EVIDENCE: All the support workers who were on duty during this site visit were observed interacting with the service users in very caring and respectful manner throughout this visit. The manager told us that a minimum of two support workers are always on duty throughout the day, but an additional third of fourth would be used as and when required to ensure the social needs and wishes of the people who used the service were met. Three members of staff, an excellent ratio of one to one were on duty at the time of this unannounced inspection. The area The Crescent DS0000071234.V366312.R01.S.doc Version 5.2 Page 21 manager told us she belied current staffing levels were adequate to meet service users social, personal and health care needs. The one member of staff who returned are comment card wrote there was ‘usually’ enough staff on duty to meet the individual needs of all the people who use the service. At night the home operates an on call system. The area manager told us three senior members of staff take it in turns to be designated on call for week. These staff all live within 20 minutes of the home and were clearly identifiable from the duty rosters. The area manager acknowledged that the home had experienced relatively high levels of staff turnover in the past year and a half. However, records revealed that five out of seven of the homes current staff team had all worked at the Crescent for many years, which indicated that the majority of the half a dozen staff who had recently left were relatively new members of staff. Furthermore, the area manager told us after a recent staff recruitment drive the home is now only one full time member of staff short of its full compliment. We agree with the area managers statement that continuity of care the people who use the service receive support from workers they are familiar with is currently not an issue at the home. The homes two recently employed members of staff were both on duty at the time of this inspection. The area manager told us Modus had carried out all the recruitment checks the organisations was legally obliged to obtain in respect of these individuals. An up to date Criminal record bureau and protection of vulnerable adult check was produced on request for one relatively new member of staff. Both staff interviewed in private told us their new employer had carried out CRB and reference checks before they had started work at the home. Both these staff also told us their inductions had been very thorough and records kept of this training revealed it had covered safe working practices, their carer role and responsibilities (including sleep ins and driving the homes vehicle), and the needs of the service users. The one member of staff who completed our survey ticked the ‘mostly’ box in response to the question ‘did your induction cover everything you needed to know about your job before you started’. All the written and verbal feedback provided by staff about the training they had received told us it was relevant to their role as support workers. The area manager had carried out a thorough assessment of the staff teams training strengths and needs, which revealed very few gaps in people’s knowledge and skills. As required in the home previous report sufficient numbers of staff have now up dated their basic food hygiene training and the vast majority are also suitably training in fire safety, moving and handling, first aid, supporting adults with autism and aspergers, managing behaviours that challenge, safeguarding protocols, handling medication in a residential care setting, and infection control. The Crescent DS0000071234.V366312.R01.S.doc Version 5.2 Page 22 Both the new staff interviewed told us they were in regular contact with the homes acting manager and had received at least one formal recorded supervision session with her since starting work at the Crescent. The one member of staff who completed our survey ticked the ‘often’ box in response to the question ‘does your manager meet with you to give you support and discuss how you are working?’ The area manager told us the homes only male service user enjoys male company, but with only one male member of staff currently employed by the service the manager is very conscious of this gender imbalance and will be mindful of it when she next recruits new staff. The Crescent DS0000071234.V366312.R01.S.doc Version 5.2 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 People who use the service experience excellent quality outcomes in this area. We have made this judgement using arrange of evidence, including a visit to this service. The people who use the service continue to benefit from living in a home that continues to be extremely well run by a very competent and knowledge management team. Recent improvements made the homes quality assurance system ensures the views of the people who use the service and their representative’s are ascertained and taken into account when making plans to develop the service. The homes health and safety arrangements are sufficiently robust to safeguard the health and welfare of the people who use the service, their guests, and staff. The Crescent DS0000071234.V366312.R01.S.doc Version 5.2 Page 24 EVIDENCE: Fiona Wild, the homes former deputy manager who has been acting up since March 2007 has now been appointed the new manager. It was evident from comments made by the area manager and other members of staff that people like her leadership style, which everyone spoke with told us was a very open and inclusive one. The acting manager has over three years experience working with adults with learning disabilities in a senior capacity and is currently studying for her National Vocational Qualification (Level 4) in management and care. The area manager who is not directly involved in the day-to-day running of the home, told us she visits the service on a regular basis and is always on hand to offer her advice and support to the new acting manager and other staff. The area manager was able to produce reports she had compiled which set out in detail her findings following monthly inspections of the Crescent. As required in the homes previous report Modus have introduced a new quality assurance system that covers every aspects of life in the home on a daily, weekly, monthly and annual basis. The system is extremely thorough and a lot of positive feedback about the standard of care provided by the home had been received by from the relatives of the people who use the service. The homes fire records revealed that the fire alarm system continues to be tested on a weekly basis and fire drills undertaken at regular intervals. During a tour of the premises it was noted that none of the homes fire resistant doors were being inappropriately wedged open to prevent there automatic closure in the event of a fire. The homes fire risk assessment of the building was recently reviewed and up dated accordingly to reflect any changes. Records showed the temperature of hot water emanating from all the homes water outlets continue to be tested on a weekly basis. All food in the kitchen is correctly stored in line with environmental standards. The Crescent DS0000071234.V366312.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 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 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 4 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 4 X X 3 X The Crescent DS0000071234.V366312.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. Refer to Standard Good Practice Recommendations The Crescent DS0000071234.V366312.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG 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 The Crescent DS0000071234.V366312.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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