Care Home: The White House

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• 10 Whitfield Avenue

What the care home does well This home provides a clean, well maintained, safe and homely environment for the people who live there. There are good records which means that staff know what support each person needs and the way they prefer to be helped. People are helped to receive the right services to maintain and improve their health. People are helped to live full lives, maintaining contact with people in the community and going on outings and holidays. People are involved in decisions about their care and life in the home. Staff make good use of technology, such as the digital camera, to make it easier for people to make choices. The staff are well qualified and receive ongoing training so that they continue to provide the right support to people in the home. This home is well managed and there are good arrangements for making sure that the high standards are maintained.The White HouseDS0000064612.V377803.R01.S.docVersion 5.3 What has improved since the last inspection? The manager has met the requirements in the last report and has put the recommendations into practice. Support plans have been improved so that they are more person centred and reflect people’s choices and needs. They have been put into the same order so that they are easier to understand. They contain pictures and photographs to make it easier for people to make choices. Activities have increased according to people’s individuals needs and choices. Menus have been improved to provide a healthy, more balanced diet. People have been provided with moore opportunities to develop life skills by helping with domestic tasks, shopping and cooking. The manager has reviewed the complaints folder. The level of staff training has improved. All staff have attended training and are working towards NVQ level 2 or 3. New cleaning rotas help to make sure that the home is clean and tidy. The manager has also reviewed the maintenance folder. There is now a full staff team and staff receive more regular supervision. Monitoring systems have improved to ensure that tasks are completed. All staff have now signed to say that they have read policies and procedures. What the care home could do better: We found that the manager has identified areas in which further improvements can be made. These are listed below. The manager plans to make further improvements to the information about the home for prospective residents, so that it will be easier to understand. The manager plans to continue to develop and amend the support plans and other paperwork throughout the home, so that more use is made of photographs instead of pictures. The manager plans to keep looking at new ideas for activities and holidays so that people can have more new experiences.The White HouseDS0000064612.V377803.R01.S.docVersion 5.3The manager plans to continue to explore ideas for minimising the effect of the office being so small. Key inspection report CARE HOME ADULTS 18-65 The White House 219 Green Lanes Wylde Green Sutton Coldfield West Midlands B73 5LX Lead Inspector Chris Lancashire Key Unannounced Inspection 6 and 12th October 2009 10:00 th The White House DS0000064612.V377803.R01.S.doc Version 5.3 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care home adults 18-65 can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop. The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. The White House DS0000064612.V377803.R01.S.doc Version 5.3 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address The White House DS0000064612.V377803.R01.S.doc Version 5.3 Page 3 SERVICE INFORMATION Name of service The White House Address 219 Green Lanes Wylde Green Sutton Coldfield West Midlands B73 5LX 0121 355 0908 F/P 0121 355 0908 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) Robinia Care West Midlands Limited Paula Adkins Care Home 7 Category(ies) of Learning disability (7) registration, with number of places The White House DS0000064612.V377803.R01.S.doc Version 5.3 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 (LD) 7 The maximum number of service users who can be accommodated is: 7 8th December 2008 Date of last inspection Brief Description of the Service: This home is a large detached property in the Wylde Green area of Sutton Coldfield. There are communal areas on the ground floor, consisting of a dining room, lounge, bathroom, toilet, laundry and kitchen. There are seven single bedrooms, two of which are on the ground floor and five on the first floor. Two of the bedrooms on the first floor have en-suite bathrooms. The office/staff sleeping in room is also on the first floor. There is a pleasant garden to the rear of the property, which consists of a paved patio area and a lawn. There is some off road parking for a few cars to the front of the premises. The home is located close to local amenities in Wylde Green and Sutton Coldfield. It is also close to bus routes for Sutton Coldfield and Birmingham. The service provides care and support services for up to seven adults with learning disabilities. The White House DS0000064612.V377803.R01.S.doc Version 5.3 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. We visited the home on a weekday, without telling anyone that we would be visiting. Before the inspection we had asked for information about how the home runs in a questionnaire called an Annual Quality Assurance Assessment. The manager provided this information. We looked round the building, looked at records, talked to the senior member of staff and met 2 people who live in the home and 3 members of the staff team. We looked at the records which the home keeps in respect of two people who live there, so that we could find out how they are being supported and kept safe. We finished this visit before we had gathered the necessary information, due to prior arrangements which the staff had made. We returned to the home a week later when we looked at more records with the manager. We also met 2 people who live in the home and looked at their rooms. We looked at other records which the home is required to keep. These included the staff training records, rotas, menus, safety records and minutes of meetings. We used this information to write this report. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. What the service does well: This home provides a clean, well maintained, safe and homely environment for the people who live there. There are good records which means that staff know what support each person needs and the way they prefer to be helped. People are helped to receive the right services to maintain and improve their health. People are helped to live full lives, maintaining contact with people in the community and going on outings and holidays. People are involved in decisions about their care and life in the home. Staff make good use of technology, such as the digital camera, to make it easier for people to make choices. The staff are well qualified and receive ongoing training so that they continue to provide the right support to people in the home. This home is well managed and there are good arrangements for making sure that the high standards are maintained. The White House DS0000064612.V377803.R01.S.doc Version 5.3 Page 6 What has improved since the last inspection? What they could do better: We found that the manager has identified areas in which further improvements can be made. These are listed below. The manager plans to make further improvements to the information about the home for prospective residents, so that it will be easier to understand. The manager plans to continue to develop and amend the support plans and other paperwork throughout the home, so that more use is made of photographs instead of pictures. The manager plans to keep looking at new ideas for activities and holidays so that people can have more new experiences. The White House DS0000064612.V377803.R01.S.doc Version 5.3 Page 7 The manager plans to continue to explore ideas for minimising the effect of the office being so small. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. The White House DS0000064612.V377803.R01.S.doc Version 5.3 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 White House DS0000064612.V377803.R01.S.doc Version 5.3 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 1,2 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People and their representatives are provided with the necessary information about the home so that they can make an informed choice about moving in. People’s needs and aspirations are fully assessed prior to coming to this home. EVIDENCE: The home has a Statement of Purpose and service user guide which provide a description of the home and the services offered. We found copies of these on the two files which we sampled. These have been updated since the last inspection and contain the necessary information. They contain pictures and text, which would provide people with enough information to make a decision about whether or not they may want to live in this home. The manager told us that there are plans to update these again to include photographs so that they will be easier to understand. The White House DS0000064612.V377803.R01.S.doc Version 5.3 Page 10 There have been no recent admissions to this home. The people who live in this home have been there for several years, so it was not possible to assess the admission process. The manager told us that before anyone moves into the home there is a full assessment to establish their needs and to make sure that the home can meet these. We saw assessments on people’s files. All people considering moving into the home are provided with the opportunity to visit, stay for a meal and have an overnight stay before making a choice. Previous inspectors have assessed the process and found it to be appropriate. The White House DS0000064612.V377803.R01.S.doc Version 5.3 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 People using the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs and personal goals are reflected in their care plans. There are very good systems for encouraging people to participate in decisions about their lives and are people are supported to take controlled risks in order to develop greater independence. EVIDENCE: The manager told us that there are plans for each person in the home so that staff know how to provide support in the way people need and prefer. These are developed from the original assessments and contain information provided by professionals, the person themselves and others who know them well. We sampled two people’s files and saw that each one contains sheets which provide basic details about the person, their likes and dislikes and how they The White House DS0000064612.V377803.R01.S.doc Version 5.3 Page 12 like to be supported. These have large photographs of the person, with speech bubbles providing information such as, ‘I like to clean my room’. There are photographs of the staff who provide support. The plans are well organised, with a page for each area in which the person needs support, for example, housing, personal care, finance and communication. The plans we looked at are detailed, with clear information about what the person wants to be able to achieve and the support which staff need to provide. They contain photographs of each task. Each sheet contains a link to the relevant risk assessment. We saw that the plans are evaluated and reviewed on a three monthly basis. Staff told us about the range of reasonable risks which people are encouraged to take in order for them to be as independent as possible. The risk assessments, which are linked to areas of the support plan, are clear and explain what the risks may be and the actions which are taken to reduce these. We saw photographs of people participating in activities for which we had seen the risk assessment. Staff provided us with an example of someone who had chosen to participate in a new activity. The manager had arranged an appointment at the venue so that she could assess the possible risks and make suitable arrangements for he person to go there. The manager told us that staff encourage each individual to take as much control and decision making over their life as they are able. Staff provided examples of the areas of people’s lives where they are encouraged to make decisions. We saw the minutes of service user meetings and these showed that people are consulted about their activities, their meals and the environment in the home. Staff have produced large laminated sheets with Velcro which allows people to choose from a selection of photographs of real food and activities, so that they can build a plan for their week, or a menu. One member of the staff team was updating a plan one the day of the inspection. We discussed the process with staff and the manager and they showed a good understanding of the need for continual updating of plans and making the best use of the technology available, such as the digital camera and computer, so that people can be better helped to communicate their choices. The White House DS0000064612.V377803.R01.S.doc Version 5.3 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): This is what people staying in this care home experience: 12,13,15,16,17. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported to take part in appropriate activities and to maintain links in the local community. Their rights are respected. They are supported to have a healthy diet and to enjoy their mealtimes. EVIDENCE: The manager told us that people are encouraged to take part in a range of activities of their choice. We saw that each person has a timetable for the week, which provides details of what they are doing on a daily basis. These show that people attend day centres, go on social outings, visit family and friends and go on holidays. Staff have produced large laminated timetables to The White House DS0000064612.V377803.R01.S.doc Version 5.3 Page 14 which people can attach photographs relating to the activities which they have chosen. We saw photographs of people enjoying pottery, cooking, and arts and crafts at various locations. These photographs act as a prompt to remind people of what they have done. There are weekly meetings of people who live in the home. We saw the minutes of these. They have photographs of each person who attended the meeting, together with clear details of the decisions which people have made, for example the choices which they have made in relation to meals and activities. When people choose a new activity, staff look at how they can be helped to attend and suitable risk assessments are carried out. The staff help people to keep in touch with relatives and friends. Some go out to visit people on a regular basis and people also have visitors at the home. We saw records of these visits. On a sampled file we saw the telephone numbers of people who the person likes to keep in contact with. These have a large telephone picture next to them. There is information for staff about the type of contact which the person prefers and the usual frequency. The risk assessments for these contacts have clear details. For example, the risk of making a certain visit is that the person could get lost and the control measure is that staff need to communicate with the person she would be visiting and also make sure that she uses a certain taxi firm as they know her support needs. People told us that they enjoy the meals. We saw a big folder with photos of meals, and items of food and packaging so that people can make choices. The cereal containers have the packet fronts on them so you can see what is inside them. The menu has Velcro so that the photos of the meals can be placed on it for each day and changed when the weekly plan is made. Staff have used the services of dieticians to assess people’s dietary needs where necessary and to provide advice about the most appropriate diet, when they have specific needs, such as a need to lose or gain some weight to remain healthy. The records show that, where people have needed support to change their weight, they have achieved change with the support of staff. The White House DS0000064612.V377803.R01.S.doc Version 5.3 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive personal support in the way they prefer and require so that their physical and emotional health needs are met. They are protected by the homes practices in dealing with medicines. EVIDENCE: The records which we sampled contain good details of people’s health needs. People are supported to use a range of healthcare services in the community. The records show that they attend appointments with various health care professionals including dentists and GPs. The manager and staff demonstrated awareness of the kinds of symptoms which may prompt the need for an appointment. They also provided us with examples of when they had advocated on behalf of people in the home to make sure that they receive appropriate services. Staff have referred people to community nurses where The White House DS0000064612.V377803.R01.S.doc Version 5.3 Page 16 needed and they also work with dieticians and other health professionals to make sure that people’s health needs are met. The records show that people have a range of different needs in terms of personal care and manual handling. Staff have received suitable training and there is suitable equipment in the home. There is suitable, secure storage for the medication. We saw risk assessments on file to show why people need support from staff to take their medication. For example one contains the comment, ‘I have no concept of time, I could take too much’. All staff who administer medication are suitably trained. We looked at the records and found that they have a section for each person, with a large photograph and protocols for staff to follow. The records of the doses have been completed with no gaps. The White House DS0000064612.V377803.R01.S.doc Version 5.3 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 22,23. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. This home has systems to ensure that the views of the people who live there are listened to and acted upon and good arrangements for protecting people. EVIDENCE: This home has a policy and procedure for dealing with complaints and the details for making a complaint are in the home’s Statement of Purpose and service user guide. The manager told us that staff also explain how to make a complaint to people living in the home as people use various methods of communication. Staff are working on a system which will make it easier for people to understand the process and communicate their concerns more easily. The manager told us that the home has received no complaints since the last inspection. People in the home told us that they are happy but would go to the manager if they had a complaint. We have not been contacted with any concerns about this home. The manager told us that all money held on behalf of people who live in the home is administered through the company’s head office. At the home, staff keep receipts and a record of the money which has been spent by or on behalf of people. We saw that these records are audited on a weekly and monthly basis. The White House DS0000064612.V377803.R01.S.doc Version 5.3 Page 18 The records show that most of the staff have received training in recognising the possible signs of abuse and the action to take should they have any concerns. We saw that additional training for the remainder of the team is planned. Staff demonstrated a good level of understanding of the issue involved in protecting people. The local procedures for safeguarding people are in the office. This means that there are good arrangements for making sure that people are kept safe. The White House DS0000064612.V377803.R01.S.doc Version 5.3 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 24,30. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people at this home live in a homely, clean, safe and comfortable environment which is well maintained and where there are good arrangements for infection control. EVIDENCE: We looked round the building and saw inside three people’s rooms. We found all areas to be clean and free from unpleasant odours and to be in a good state of repair and decoration. The living and dining rooms are homely and have suitable facilities. The kitchen is large enough for its purpose and is not institutional. The bedrooms which we saw are decorated in an individual way, with personal items, such as ornaments, pictures and soft toys. The White House DS0000064612.V377803.R01.S.doc Version 5.3 Page 20 The garden is accessible and has a patio, lawned area and flower beds. People living at the home have grown vegetables on the patio in tubs and in a portable greenhouse. The bins are well screened from the rest of the garden. Mention has been made of the small office in previous reports. This is a small room, which also houses the sleeping-in bed for staff. There is very little storage space for documents and the room is full when there are two people in there. The manager told us that she has explored solutions to this problem. One involves raising the bed, to create more storage space below. This may, however, create access and health and safety hazards for staff using the bed. The manager told us that she will continue to look at possible solutions but it would be impossible to take more space for office use without using space presently used by people who live in the home. There are procedures for the control of infection and staff confirmed that they have access to gloves and aprons when required. The manager told us that all staff have attended Health and Safety and infection control training. These measures help to make sure that people are kept safe in the home. The White House DS0000064612.V377803.R01.S.doc Version 5.3 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 32,24,25. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported by adequate numbers of appropriately trained and competent staff so that their needs are met. They are protected by the homes recruitment practices. EVIDENCE: The manager told us that staff are recruited through a standard process which includes taking up references and checks through the Criminal Records Bureau. Staff do not start work until the checks are completed and they receive induction training which meets the current requirements. We looked at records which confirmed this and spoke to staff about their training. Staff told us that they are encouraged to undertake NVQ training and in addition, they attend various courses which are relevant to their roles. There are good arrangements for making sure that people update training in various The White House DS0000064612.V377803.R01.S.doc Version 5.3 Page 22 areas and we saw that several dates had been booked for the near future. The records show that all staff except for one person have at least NVQ level 2 or are working towards it. One person has level 4, four people have level 3 and three people are working towards level 3. The manager has recently completed ‘train the trainer’ training for manual handling. The manager told us that there are regular staff meetings and we sampled the minutes of these. They show that staff are involved in making decisions about possible changes and future work. The manager showed us the dates for staff supervision on a six weekly basis and we also saw the records of some sessions in staff files. Staff told us that they feel well supported by the manager and the company. The staff rotas show that there is adequate cover to meet the needs of the people in the home. Rotas are changed to take account of the activities and needs of the people in the home. The records show that the staff team has been more stable during the past year. This means that people are supported by staff who know them and their needs. The White House DS0000064612.V377803.R01.S.doc Version 5.3 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who live in this home benefit from a well run home where their views underpin self monitoring, review and development. Their health, safety and welfare is promoted and protected. EVIDENCE: The registered manager is suitably qualified and experienced to run the home. She is well supported in her role by a team of senior staff who are trained in managing people. All the staff who assisted in the inspection demonstrated a good level of knowledge about the needs of each of the people in the home. The White House DS0000064612.V377803.R01.S.doc Version 5.3 Page 24 People who live in the home are consulted about many aspects of its day to day management, such as daily routines, menus and outings. The home also sends surveys to people, but the manager and staff told us that they communicate with people directly to obtain their views. There are systems, such as checklists to make sure that the high standards of service are maintained and we saw from the records that the manager makes sure that policies, procedures and other systems are kept up to date. We saw that the manager carries out regular audits in areas such as accidents, complaints and finances. There are monthly visits from representatives of the company and we saw the reports of some of these visits. The manager has an action plan, based on the findings of the visits and the last inspection. This shows that there is constant updating and improvement of records. For example, it includes a plan to update the individual fire risk assessments. This demonstrates that there are regular checks on all aspects of the home to make sure that high standards are maintained and improved upon. We saw risk assessments for the building, fire, people and tasks. These are clear and provide details of the measures which have been taken to reduce risks. Before the inspection, the manager provided us with information about the dates of the servicing and checking of equipment in the home. We checked a sample of dates against the records and found them to be correct. This shows that there are good arrangements to make sure that people who use the building are kept safe. The White House DS0000064612.V377803.R01.S.doc Version 5.3 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 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 4 33 X 34 3 35 3 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 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Version 5.3 Page 26 The White House DS0000064612.V377803.R01.S.doc 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 White House DS0000064612.V377803.R01.S.doc Version 5.3 Page 27 Care Quality Commission West Midlands Region Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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