Care Home: The Red House

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What the care home does well There are excellent systems in place to assess the needs of people wishing to move into the home. This helps them and people involved in their care to make an informed decision about whether the home can meet their needs. People living at the home are also involved in this process. People are involved in identifying their wishes and aspirations and monitoring whether these are being met. Excellent records are being maintained with evidence of regular review and their say in this process. People are supported to be independent and decisions they make are respected. One person was observed being supported to make decisions about their hairstyle and another to budget their personal allowance. Over 50% of the staff team have a NVQ Award in Health and Social Care. People are involved in the quality assurance systems within the home and take pride in the roles they have taken on. One person has responsibility for monitoring health and safety and another represents people at a `Your Voice` forum organised by Craegmoor. What has improved since the last inspection? The home has been supplied with satellite television improving the reception within the home. A new carpet has been fitted in a hallway on the ground floor and a ceiling replaced in a bathroom. There has been a significant reduction in the use of physical intervention and success supporting people to manage their behaviours. CARE HOME ADULTS 18-65 The Red House 65 Ruspidge Road Cinderford Glos GL14 3AW Lead Inspector Ms Lynne Bennett Key Unannounced Inspection 11 and 16th October 2007 10:00 th The Red House DS0000043069.V348140.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 Red House DS0000043069.V348140.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 Red House DS0000043069.V348140.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Red House Address 65 Ruspidge Road Cinderford Glos GL14 3AW 01594 822100 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) red.house@craegmoor.co.uk Craegmore.co.uk Park Care Homes (No 2) Ltd To be appointed Care Home 8 Category(ies) of Learning disability (8) registration, with number of places The Red House DS0000043069.V348140.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26th August 2006 Brief Description of the Service: The Red House is a detached care home situated in a residential area a couple of miles from the centre of the town of Cinderford. It is one of seven homes in Gloucestershire owned by Craegmoor. The home provides accommodation and care for up to eight adults with learning disabilities who may also have challenging behaviour. The accommodation is spread over three floors and the home is surrounded by terraced gardens. There is a shop and pub nearby. Fees were reported to be an average of £1224.95 per week. Prospective service users and people involved in their care are offered information about the home and the opportunity to visit where appropriate. The Red House DS0000043069.V348140.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. 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 inspection took place in October 2007 and involved two visits to the service. The registered manager was present during the second visit. People living at the home and staff were spoken with during the first visit. The care being provided to people was also observed on this occasion. The registered manager completed an AQAA (Annual Quality Assurance Assessment) as part of the inspection, providing considerable information about the service and plans for further improvement. Surveys were returned from three people living at the home and four parents or relatives. A sample of records were examined which included care plans, staff files, health and safety systems and quality assurance audits. What the service does well: There are excellent systems in place to assess the needs of people wishing to move into the home. This helps them and people involved in their care to make an informed decision about whether the home can meet their needs. People living at the home are also involved in this process. People are involved in identifying their wishes and aspirations and monitoring whether these are being met. Excellent records are being maintained with evidence of regular review and their say in this process. People are supported to be independent and decisions they make are respected. One person was observed being supported to make decisions about their hairstyle and another to budget their personal allowance. Over 50 of the staff team have a NVQ Award in Health and Social Care. People are involved in the quality assurance systems within the home and take pride in the roles they have taken on. One person has responsibility for monitoring health and safety and another represents people at a ‘Your Voice’ forum organised by Craegmoor. The Red House DS0000043069.V348140.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. The Red House DS0000043069.V348140.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 The Red House DS0000043069.V348140.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): 2,3 and 4. People who use the service experience excellent quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People have access to the information they need enabling them to make a decision about whether they wish to live at the home. A comprehensive assessment of the person’s wishes and needs are taken into consideration before offering them a place. EVIDENCE: The manager stated that she has striven to ensure that the admissions process includes a full assessment of the person’s needs so that an informed decision can be made about whether or not their needs can be met. The file for one person who had moved into the home last year was examined. This contained a copy of Craegmoor’s ‘Outcome based evaluation’ and information from their previous service providers. Comprehensive records were in place evidencing the admissions procedure. Admission records confirmed that visits to the home had taken place by parents and the social worker. Staff from the home had also visited the person in their former day centre and at home. Meetings had been held with the local Community Learning Disability Team about the transition to the home and The Red House DS0000043069.V348140.R01.S.doc Version 5.2 Page 9 continuing support from them. A copy of ‘My autistic spectrum disorder profile’ had also been supplied to the home giving clear guidelines about the person’s world, routines and comprehension. A seven-month review had been held to confirm the ongoing placement. The Red House DS0000043069.V348140.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 and 9. People who use the service experience excellent quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People are involved in decisions about their lives and play an active role in planning the care and support they receive. Risk assessments safeguard people from possible harm. EVIDENCE: The care of three people was case tracked and other files sampled. This involved reading care plans, examining financial and medication records, talking to the people and staff about the care provided and observing them during a visit. Person centred plans were being put in place for people in addition to their present support plans. These had not been developed for everyone. A person centred approach was already in place in the home. Staff and managers described how people were involved in developing and monitoring their plans. The Red House DS0000043069.V348140.R01.S.doc Version 5.2 Page 11 People were observed being involved with staff writing their daily notes. There was evidence that people had signed their plans where appropriate. People said they liked the summary of information about their likes and dislikes that provided staff with a snapshot of their needs. Each person had a current assessment in place. The home uses the Star profile to assess each person and from this support plans were developed for a range of physical, intellectual, emotional and social needs. All plans had been reviewed each month with good evidence that key workers were monitoring changes in need. Where appropriate support plans referred in the text to risk assessments, behaviour management plans or protocols. Staff spoken with had a good understanding of peoples’ needs and the support they required. Staff were observed supporting people in line with their guidelines in their plans. The AQAA indicated that reviews including the placing authority and relatives were being held every two years and that advocates were involved with people helping them to express their wishes. Care plans provided information about advocacy services and named advocates for people. Plans referred to the way in which people could be supported to make choices and be independent in their day-to-day lives. People were observed being involved in making choices such as where to go for lunch or how to spend their time. People clearly had responsibilities within their home for activities of daily living such as helping to wash up or helping with the laundry. People were being supported to manage their personal allowances. Good records were being kept with regular checks evident. Staff stated that management complete spot checks and that Craegmoor had recently conducted a financial audit. One person was observed discussing how to budget their allowance so that they could do some shopping but also leave sufficient money for the rest of the week. Comprehensive communication profiles were in place that provided staff with clear information about the support people need to express themselves and how to interpret non verbal behaviour. Regular house meetings ensure that people have a chance to express their views. Minutes of these meetings confirmed that people were being given information about their home such as the appointment of new staff and changes to the environment. Comments from people living at the home gave positive feedback about being involved in the redecoration of their rooms. Risk assessments were in place that were cross referenced with hazards identified in care plans and to behaviour management plans. People were being supported to take risks in a managed way reducing any identifiable hazards. Regular review of these records was well evidenced. The Red House DS0000043069.V348140.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): 12,13,14,15,16 and 17. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who live at the home make choices about their lifestyle, and are supported to develop life skills. They have the opportunity to take part in social, educational and recreational activities and keep in touch with family and friends. The home is striving to provide a nutritional diet to people. EVIDENCE: Each person has an activity schedule that staff said was being regularly reviewed with them. One person’s timetable has been produced in a format appropriate to their needs with good use of symbol, picture and text. During the visits to the home people were observed using public transport to go to the nearby town, coming home from college courses or a day centre, going shopping in Gloucester and helping around the home. Staff discussed with people what they wished to do and when and respected their decisions. People said they enjoyed going to a social club, using a music library and going out for lunch. The Red House DS0000043069.V348140.R01.S.doc Version 5.2 Page 13 House meeting minutes indicated that people were thinking about holidays ready for next year. At one meeting a person suggested that they have a Chinese meal one evening. The minutes for the next meeting included people’s views on the meal which they had all enjoyed and asked to have again. The AQQA states that “the activities that the residents participate in are built individually around each individual’s independence, goals, likes, dislikes and choices”. This was confirmed through discussion with people, staff and by examination of daily records and care plans. The AQAA also indicates that there continue to be concerns about the activities budget meeting the needs of people. Staff stated that the college had started charging for attendance at their courses. Staff commented that sometimes due to lack of drivers or a reduction in the home’s vehicles (from three to two) people were restricted in accessing some activities. The manager confirmed that all people now have bus passes and that Craegmoor had just notified her that another vehicle was to be provided for the home. Three members of staff had also recently become available to drive the vehicles. Staff were observed treating people with dignity and respect. One person was referred to by a nickname and staff confirmed that this was her choice and had been recorded in her care plan. Not all people have keys to their rooms. One person was observed locking their room prior to leaving the house. People have regular contact with family and friends. Records were being kept which indicated that people like to keep in touch by telephone, visits or writing letters. Parents commented that they were always made to feel welcome. People living at the home were being involved in the choice of meals provided. There was evidence that at house meetings staff have discussed healthy eating options. The Community Learning Disability Team had raised concerns about the diet of one person. A dietician was due to visit the home to offer advice and training for staff. A chart monitoring their diet was in place. All people were being weighed on a regular basis. Fresh fruit was available in the home for snacks and people were observed helping themselves to drinks. Comprehensive records were being kept of the meals provided to people indicating when alternatives were provided. There was no way of determining the diet of individual people from these records. The Red House DS0000043069.V348140.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 and 20. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People’s health and personal care needs are being met helping them to stay well. Their health and wellbeing are promoted by satisfactory arrangements for the handling of medication and training of staff in specialised techniques. EVIDENCE: The new Person Centred Plans had sections entitled ‘What I do’ and ‘What I like to do’ and also included a communication profile. Staff were observed supporting people to make choices about their personal care. People’s preferences for personal support include reference to the gender of staff they would prefer to have care from and any particular cosmetics they prefer to use. For example one person was being supported to choose a new hairstyle, changing the colour and the cut of their hair. One person has epilepsy and a listening device was in place. Throughout the duration of the first visit this was switched on in the main office near to the lounge. A care plan indicated that this was to be used to prevent injury or harm. A protocol needs to be in place detailing when the device is to be used The Red House DS0000043069.V348140.R01.S.doc Version 5.2 Page 15 and giving consent for this. The manager confirmed that a review was due and that this would be done then. Healthcare contact sheets were being kept for appointments with a range of healthcare professionals indicating that people have regular access to their GP, Dentist, Optician, Chiropodist and members of the Community Learning Disability Team. There was evidence that people were being supported with outpatient appointments. There was also evidence that annual health checks were in place with one person attending a ‘Well Man check’. The AQAA indicates that Health Action Plans were still to be put in place and that the manager was going to introduce a summary sheet of healthcare appointments as an easy quick reference guide. Staff confirmed that they complete training in the administration of medication and that the manager assesses their competency on a regular basis. There was evidence on the medication administration records that new staff shadow existing staff. They then double sign the record when medication has been taken. This is good practice. Medication reviews were seen to be taking place. Systems for the administration of medication were satisfactory. For instance sample signatures were in place, creams and liquids were labelled with the date of opening and procedures were in place for the administration of ‘as necessary’ medication. The Red House DS0000043069.V348140.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 and 23. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People are confident in the knowledge that any concerns they may express will be listened to and acted upon. Systems are in place that safeguard people from possible harm or abuse. EVIDENCE: The home has a complaints policy and procedure that was displayed in the entrance hall. Each person living at the home has a personal copy on their files, which they were observed having access to. People attend regular house meetings where they can discuss concerns. For instance one person was concerned about the vehicles, one was breaking down with regularity and they mentioned this at two meetings. This had not however been logged as a complaint. As mentioned the manager had just received confirmation from Craegmoor that an additional vehicle would be provided. A complaints folder was in place. No complaints had been logged by the home. Staff stated that they have attended training in the safeguarding of adults and in Crisis Prevention Intervention (CPI). Those spoken with had a good understanding of how to support people to manage their behaviour and to protect others from possible abuse. The manager confirmed that there had been a significant reduction in the use of physical intervention in the home with the success of the use of non-aversive techniques. Staff were observed using distraction and diversion effectively during the visits. Staff confirmed that they work closely with a Consultant Behaviour Therapist. There was The Red House DS0000043069.V348140.R01.S.doc Version 5.2 Page 17 evidence that behaviour management plans were being regularly reviewed. Staff commented that one person had chosen to use a reward system to help them to manage their behaviour and that they had responded well to this. The Red House DS0000043069.V348140.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): People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Planned refurbishments to the home will provide spacious communal areas and ensure that people live in a safe environment. EVIDENCE: The manager shared with us plans for refurbishment of the home. She had asked for changes to be made to these and had a revised version available for inspection. Discussions focussed on a new downstairs shower and toilet and the appropriate place for the door to this room. In the present version it appeared to go into the kitchen. The manager said she would address this with the architect. An application had been made to the local planning office for an extension to the home as part of these refurbishments. Some carpets in the house had been replaced; others such as the lounge and stairs would be replaced when the refurbishments are completed. Rooms were pleasantly decorated and people said they had been involved in the choice of The Red House DS0000043069.V348140.R01.S.doc Version 5.2 Page 19 colour scheme. Bathrooms were clean at the time of the visits. A ceiling in one of the bathrooms had been replaced due to problems with mould. Since the last inspection the home has had satellite television installed significantly improving television reception at the home. People said they were pleased with this. Several pillows looked they needed replacing. Regular checks should be put in place to monitor the state of bedding. The home has a maintenance person for day-to-day repairs and redecoration and staff said that the home had benefited from this input. The grounds around the home were in good condition providing several areas for people to enjoy games and barbeques in the summer. The laundry will be moved to away from the kitchen when the refurbishment is completed and will substantially improve the present facilities. Personal protective equipment is provided and liquid soap and paper towels were in place throughout the home. The Red House DS0000043069.V348140.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. People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Peoples’ needs are met by a competent staff team, who have access to a mainly satisfactory training programme that needs to ensure staff have knowledge about the diverse needs of people living at the home. Improvements in recruitment and selection procedures will ensure that people are being safeguarded from possible harm. EVIDENCE: Relationships between staff and people living at the home appeared to be positive and mutually respectful. Staff conducted themselves professionally. People said they liked staff at the home. Feedback from parents was also favourable. There have been some changes to the staff team over the past twelve months but staff spoken with said that these have been positive and that moral within the team is very good. The team consists of a mix of experienced staff with the knowledge, skills and experience needed to support people and staff new to care. People confirmed that they complete an induction and have access to The Red House DS0000043069.V348140.R01.S.doc Version 5.2 Page 21 a NVQ programme. The manager stated that nine staff have a qualification, four staff were completing their awards and two were about to be registered. This exceeds the standard of 50 of the staff team to have a NVQ award. Files for new staff were examined and several issues were identified. The manager must ensure that where there are gaps in employment history these are questioned and reasons recorded. The interview form used by Craegmoor provided a prompt for this and there was evidence that this information had been obtained for one person. The reference request form used by the home does not request from former employers the reason why staff left their employ. There was also no evidence that this information had been obtained for positions where people had previously worked with vulnerable adults or children. One person stated at their interview that they wished to work at the home because they had enjoyed working in a domiciliary care agency with older people. There was no mention of this in their employment history on their application form. This information must be obtained and they worked in this position within the last five years, the reason for leaving must be obtained. There was evidence that people were not being appointed until receipt of two satisfactory references and a Criminal Records Bureau check were in place. Evidence of each person’s identity and a current photograph were on their files. Criminal Records Bureau checks were sampled and the manager was informed that originals could be disposed of. The home has access to a robust training programme. A training matrix was examined confirming that staff attend mandatory training with refresher courses when needed. Supervision records confirmed that training was being monitored and any additional training identified. Staff did not appear to have access to training specific to the needs of the people living at the home such as mental health, autism or epilepsy. The manager stated that she had been searching a provider for these areas. The Red House DS0000043069.V348140.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. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The management and administration of the home is based on openness and respect. Effective quality assurance systems are in place involving people who live at the home. The safety of people living at the home is being put at risk as a result of delays to attend to hazards in the home. EVIDENCE: The manager is experienced in this area of care and has worked for Craegmoor for some years. She has a NVQ Level 3 in Health and Social Care and has completed the Registered Managers Award. She was due to start the NVQ Level 4 in Health and Social Care. She has started the process to become registered as the manager for the home with the Commission. People living at the home, staff and parents commented on her openness, transparency and the improving standards of care. The Red House DS0000043069.V348140.R01.S.doc Version 5.2 Page 23 Craegmoor has a quality assurance system in place that includes people living at the home. Regular quality assurance audits were being completed by the manager and by external departments. The manager stated that a recent clinical governance audit involved face-to-face discussions with people living at the home. The audits reveal improving standards within the home over the past twelve months. Unannounced visits to the home were being conducted each month and copies of the reports being forwarded to the Commission. A person living at the home has been chosen to represent people at forums and conferences held by Craegmoor. Another person has responsibility for monitoring health and safety within the home and has asked if they can attend the health and safety meeting with staff. This was being arranged. Staff complete monthly health and safety checks around the home and had noted that the tumescent strips on some fire doors need urgent attention. This had been reported to the manager. She confirmed that a requisition had been completed but that the work was outstanding. A fire risk assessment was in place and systems in place to monitor fire equipment. COSHH data sheets were in place and hazardous products stored securely. Good food hygiene practice was observed to be in place. Systems were in place for the monitoring of water temperatures. The Red House DS0000043069.V348140.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 4 3 4 4 4 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 1 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 4 33 X 34 1 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 X 3 X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 3 3 X 3 X 4 X X 2 X The Red House DS0000043069.V348140.R01.S.doc Version 5.2 Page 25 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA18 Regulation 12(3) Requirement Where a listening device is used to prevent harm to people who have epilepsy, the reasons for this and consent from the person or a representative must be recorded. Provide plans and a schedule for the necessary improvements to the dining and kitchen areas. Timescale of 31/05/06 not met. (This requirement has been repeated from the last two inspections-timescale for action 31/05/06 and 31/10/06). Before employing new staff the reason for leaving former positions supporting vulnerable adults or children must be obtained in writing. Ensure that there is a full employment history for people working in the care home, together with a satisfactory written explanation of any gaps in employment. (This requirement has been repeated from the last inspection-timescale for action 31/10/06). DS0000043069.V348140.R01.S.doc Timescale for action 30/11/07 2. YA24 23 31/10/07 3. YA34 19((1)(c) Sch 2. 31/10/07 4. YA34 19 31/10/07 The Red House Version 5.2 Page 26 5. YA35 18(1)(a) 6. YA42 23(4A) Staff need to have an increased awareness of the needs of people they support in areas such as mental health, autism and epilepsy. This is to make sure that they have the knowledge and skills to support people. Fire doors must close properly and tumescent strips must be in place. This is to make sure that people are protected from possible harm due to fire. 31/03/08 30/11/07 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. 3. 4. 5. Refer to Standard YA12 YA17 YA19 YA22 YA24 Good Practice Recommendations Consider whether the activities budget is sufficient to meet people’s needs, wishes and aspirations. On the meal records indicate who has had the alternative option. Look into ‘Health Action Planning’ and the formats available. Consider implementing this in the home. Any concerns expressed at house meetings should be recorded on the complaints file and the outcome logged. Pillows and bedding should be checked and replaced where necessary. The Red House DS0000043069.V348140.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Gloucester Office Unit 1210 Lansdowne Court Gloucester Business Park Brockworth Gloucester, GL3 4AB 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 Red House DS0000043069.V348140.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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