Care Home: Troutbeck Care Home

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What the care home does well The home performs well in all areas and all the outcome groups have been judged to be either "good" or "excellent".People made many positive comments about Troutbeck and the service it provides, examples of these are: `Very happy here.` `One hundred per cent, its excellent.` `Excellent warm and comfortable food varied and appetising, attention as good as can be expected. staff respectful and friendly. Fortunate dropped on my feet coming here.` `Mostly staff and management very helpful & very happy living here.` People`s care needs are properly assessed and they are given the opportunity to stay at the home before they move in permanently. This helps them make an informed decision about whether Troutbeck is the right place for them to live. A good choice of food and drinks are available. This ensures that people receive a varied and nutritious diet. People told us the, `The food is very good` and `Excellent.` Visitors are encouraged and made welcome. Troutbeck is a very clean and comfortable home, which contains the adaptations necessary to meet the people`s individual needs. This helps people remain independent. There is a clear and user-friendly complaints procedure and complaints are taken seriously. Arrangements are in place to measure the quality of the service, which includes feedback from people. This ensures that the staff continues to deliver care in the best interests of people who use the service. When staff come for a job at Troutbeck all the right references and police checks are completed, this means that it is less likely that unsuitable staff are employed to work at the home. What has improved since the last inspection? At the last inspection there were only three good practice recommendations made all of these have been followed by the management. What the care home could do better: Troutbeck does everything they have to do to run the home properly and they are always looking at ways to improve how they do things, therefore no requirements or recommendations have been made on this inspection. CARE HOMES FOR OLDER PEOPLE Troutbeck Care Home Crossbeck Road Ilkley West Yorkshire LS29 9JP Lead Inspector Caroline Long Key Unannounced Inspection 9th September 2008 09:08 X10015.doc Version 1.40 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 Troutbeck Care Home DS0000071045.V371852.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 Older People. 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. Troutbeck Care Home DS0000071045.V371852.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Troutbeck Care Home Address Crossbeck Road Ilkley West Yorkshire LS29 9JP 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) 01943 602755 01943 816768 troutbeck@mmcg.co.uk Maria Mallaband Ltd Enid Harris Care Home 54 Category(ies) of Old age, not falling within any other category registration, with number (54), Physical disability (54) of places Troutbeck Care Home DS0000071045.V371852.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 with nursing - Code N, to service users of the following gender: Either, whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP, Physical disability - Code PD. The maximum number of service users who can be accommodated is: 54. 19th September 2006 2. Date of last inspection Brief Description of the Service: Troutbeck provides nursing care to older people and has a number of places dedicated to the care of people with terminal illnesses. The home has wheelchair access. There are fifty-four bedrooms, all have their own toilet and washbasin and some have an en-suite bath or shower. The home is set on three floors and there is a passenger lift serving all floors. The ground floor has two dining rooms. There are three comfortable lounge areas and a bar. The bar area is used mainly as a coffee lounge during the day and it can be booked by people for private parties. It is situated in the town of Ilkley and is set in its own grounds with good views over the town and surrounding moors. The town centre is nearby and has public transport links by rail and bus to Leeds and Bradford. Current information about services provided at Troutbeck is in the form of a statement of purpose, service user guide and the most recent inspection report published by the Commission for Social Care Inspection are available by contacting the home. Information provided by the Registered Manager on 16th September 2008 indicated that the current weekly fee for the home is from £550 to £950 per week, dependent upon the size and location of the room. Additional costs include the provision of extra support by staff, toiletries, hairdressing, holidays, leisure activities and clothes. Troutbeck Care Home DS0000071045.V371852.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 3 star. This means the people who use this service experience Excellent quality outcomes. This is what we used to write this report: • • • • We looked at information we have received about the home since the last key inspection. We asked for information to be sent to us before the inspection, this is called an annual quality assessment questionnaire (AQAA). We sent surveys to people living in the home. One inspector visited the home unannounced. This visit lasted over six hours and included talking to the staff and the registered manager about their work and the training they have completed, and checking some of the records, policies and procedures the home has to keep. We spent time talking with six people who live in the home and a relative. We looked at four people’s care records to check that a plan had been formulated which helped staff provide support to people according to their needs and wishes. We focused on the key standards and what the outcomes are for people living in the home, as well as matters, which were raised at the last inspection. • • • We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations - but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. What the service does well: The home performs well in all areas and all the outcome groups have been judged to be either “good” or “excellent”. Troutbeck Care Home DS0000071045.V371852.R01.S.doc Version 5.2 Page 6 People made many positive comments about Troutbeck and the service it provides, examples of these are: ‘Very happy here.’ ‘One hundred per cent, its excellent.’ ‘Excellent warm and comfortable food varied and appetising, attention as good as can be expected. staff respectful and friendly. Fortunate dropped on my feet coming here.’ ‘Mostly staff and management very helpful & very happy living here.’ People’s care needs are properly assessed and they are given the opportunity to stay at the home before they move in permanently. This helps them make an informed decision about whether Troutbeck is the right place for them to live. A good choice of food and drinks are available. This ensures that people receive a varied and nutritious diet. People told us the, ‘The food is very good’ and ‘Excellent.’ Visitors are encouraged and made welcome. Troutbeck is a very clean and comfortable home, which contains the adaptations necessary to meet the people’s individual needs. This helps people remain independent. There is a clear and user-friendly complaints procedure and complaints are taken seriously. Arrangements are in place to measure the quality of the service, which includes feedback from people. This ensures that the staff continues to deliver care in the best interests of people who use the service. When staff come for a job at Troutbeck all the right references and police checks are completed, this means that it is less likely that unsuitable staff are employed to work at the home. 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. Troutbeck Care Home DS0000071045.V371852.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Troutbeck Care Home DS0000071045.V371852.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 1 and 3. People who use the service experience Excellent quality outcomes in this area. People will be assessed before admission to the home to make sure Troutbeck is the right place for them. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: Information is made available to anyone interested in moving into the home. Usually the registered manager will visit them at their home and complete an assessment to make sure Troutbeck will be able to provide a service that will meet the person’s needs. As part of this process they will also gather information form any other agencies involved. Where possible the person is then encouraged to visit the home, for a day or overnight providing them with the opportunity to meet everyone and to get a feel for the home. Staff explained significant time and effort is made to make sure admissions to Troutbeck are personal and well managed. They described how they will prepare the room meet and greet the person to make sure they feel welcome Troutbeck Care Home DS0000071045.V371852.R01.S.doc Version 5.2 Page 9 and how often visitors are encouraged to stay for a while to help the person settle in. Two peoples files that had recently moved into the home were looked at in detail and both confirmed good practice. Both contained pre admission assessments, which included details of every aspect of people’s daily life and health needs. Examples of the information included were health and personal care needs, mobility, and nutrition. Although these were not dated people living in the home were able to tell us that the registered manager had visited them. They also contained information from other health professionals that had been obtained before the person moved into the home. Both the pre-assessment and the health information from the professionals would have enabled the registered manager to make a informed decision about whether the home has the staff skills and equipment necessary to look after the person properly. One person described in detail how registered manager visited them whilst in hospital. They told us how the grateful they were when the registered manager on their request had helped them move speedily into the home. Two others told us they had been unable to look around the home themselves but relatives had visited and looked around on their behalf. Seven people who returned their surveys stated they did receive enough information about the home and did have a contract in place. People also told us the home was meeting all their care and social needs. The staff records showed and staff confirmed the necessary induction and training to enable them to look after people properly. The Statement of Purpose and Service User guide were updated in March 2008. The Service User guide provides clear information about the range of services offered by the home, the format is easy to read and there is a copy in every bedroom. People are informed that a large print version is available on request. The home does not provide intermediate care. Troutbeck Care Home DS0000071045.V371852.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7, 8, 9 and 10 People who use the service experience Good quality outcomes in this area. People can be confident the health and personal care they receive is based on their individual needs. The principles of respect, dignity and privacy are followed. We have made this judgement using a range of evidence, including a visit to this service EVIDENCE: Positive people told us they received the care and support they need, Examples of comments made were: ‘Very well looked after.’ ‘One hundred per cent excellent.’ ‘Provides them with good value for money.’ Eight surveys received from relatives and those spoken with during the visit to the home indicated that Troutbeck usually provides people with the support needed. People told us staff respected their privacy and dignity. They were able to give examples as to how staff did this. Staff were observed providing support in a Troutbeck Care Home DS0000071045.V371852.R01.S.doc Version 5.2 Page 11 kind and helpful manner and people were clean and dressed in co-ordinating clothes. People confirmed the home provides a good laundry service. Four peoples’ case records were looked at in order to check that a plan had been formulated which helped staff provide support to people according to their needs and wishes. The care plans consisted of assessments of personal and health care, which are carried out following moving into the home, these are person centred and provided good information on which to base a plan of care for people. They all contained plans that identified the individual’s personal and health care needs. The plans covered aspects such as safe environment, communication, continence, mobility, socialising, washing and dressing, and social needs. These were supported by risk assessments, which described the possible risks to people, and the actions the staff needed to take to minimise these risks. These included fall, nutritional, oral assessment, pain, infection risk, and bed rails. Both the care plans and the risk assessments had been reviewed regularly. The person or their representatives had signed some parts of the plans and risk assessments. The deputy manager and the staff were able to tell us about peoples care needs and personal preferences and how they are proactive about identifying any changes to a persons health and consulting with health professionals. Although only the nursing staff update the care plans the care staff [explained they have very good handovers at the beginning of a shift where they are updated about peoples needs. They said they did look at the care plans when they needed more information. People’s health care needs are promoted and maintained. The records showed people were accessing health care professionals, such as General Practitioners, and Chiropodists. Comments made by two health professionals were:‘Well qualified sensible nursing staff.’ ‘I feel they give 100 to good symptom control.’ A relative also told people receive the medical support they need and they are always kept well informed. There is a medication procedure to guide the staffs practice and training is provided on safe storage, administration and disposal of medicines. A monitored dosage system is used, the nurses are responsible for administering all the medication in the home. The deputy manager explained she is responsible for making sure systems are in place to make sure people receive the correct medication. A sample of medication was checked and was correct. Troutbeck Care Home DS0000071045.V371852.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 14 and 15 People who use the service experience Good quality outcomes in this area. People can choose how they spend their day and have the opportunity to pursue their own interests. Meals provided are nutritious, are of good quality and freshly prepared. This judgement has been made using available evidence including a visit to this service EVIDENCE: The atmosphere at the home was very calm and relaxed. People can sit in communal lounges or spend time in their rooms and can rise and retire as they wish. There is a range of activities for people to take part in if they wish, for instance various performances by entertainers, knitting groups, exercise groups and quizzes. The home also has themed meals such as Italian and Indian. The home are also involved in sponsoring various local community events such as the Flower festival. Families and friends are invited and notices are displayed of dates of events. The registered manager also told us the home has recently been given a computer and people will be provided with lessons on how to use Troutbeck Care Home DS0000071045.V371852.R01.S.doc Version 5.2 Page 13 it and a library service is now available. The home also has a mini bus available and uses this to take people to various local events and places, for instance Bolton Abbey for tea. People told us there were enough activities available and they could choose whether they wanted to take part or not. A relative explained how they were always made to feel welcome and offered a cup of tea when they visited. People living in the home when asked in the surveys, are there activities arranged by the home that you can take part in four said always, and two said usually and two said sometimes. Meals were seen to be an occasion; people can either eat in their rooms or have a choice of the two dining rooms. One is staffed by care staff and is used by people who need help with eating. The other dining room, where people do not need help with eating has waitress service. Staff were observed helping people in a discrete unhurried manner, some were talking to people as they help them. There is a good choice of menu for each mealtime; tables are set with tablecloths and matching crockery and cutlery. People have a choice of drinks throughout the day and sherry is offered in the bar before a meal. The chef was fully aware of the dietary people’s dietary preferences and needs. People told us the food was excellent and they are given a choice of what they wanted to eat. Troutbeck Care Home DS0000071045.V371852.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 and 18. People who use the service experience Excellent quality outcomes in this area People are able to express their concerns and are safeguarded from harm. We have made this judgement using a range of evidence, including a visit to this service EVIDENCE: Five people living at told us they feel able to make their views known if they have any concerns or complaints. Eight surveys returned all said they knew who to speak to if they were unhappy, and all knew how to make a complaint. People said that they felt comfortable to approach the manager and raise any issues. One person told us their concerns had been responded to and resolved. The survey carried out by the home in August 2007 showed that people felt they could approach the registered manager and staff to discuss concerns without any fear of reprisal. The homes complaints policy is part of the service user guide. There have been four complaints since the last inspection, which have been responded to and resolved by the registered manager or the operational manager. There are regular meetings in the home where people can make their views known. People are also encouraged to use the local advocacy service or their health professionals for support if they have any concerns. A copy of the local policy and procedure, “No Secrets”, is available for reference. Any incidents or issues at the home have been appropriately referred to the Adult Protection Unit, to ensure that individuals were safeguarded. Troutbeck Care Home DS0000071045.V371852.R01.S.doc Version 5.2 Page 15 Discussion with the registered manager showed she was aware of the actions to take to safeguard adults. Staff had received training in adult protection and safeguarding issues either during induction or as part of their national vocational qualifications and three told us they were aware of whom to alert if an incident occurred. The registered manager explained that staff are made aware of how to ‘blow the whistle’ on bad practice. There was evidence in people’s records to show that anywhere any equipment was used, which may have limited a person their consent was obtained. Troutbeck Care Home DS0000071045.V371852.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19 and 26. People who use the service experience Excellent quality outcomes in this area. The home is decorated and furnished to a high standard and provides a comfortable, safe and very pleasant place for people to live. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: The home has recently had an extension and refurbishment, and it is decorated to a very high standard. It is very comfortable and very clean and people told us this was always the case. The provider has made sure the new living areas are appropriate for the particular lifestyle and need of the people who live there. There are a number of areas were people can meet and three different types of lounges, there are various sheltered courtyards where people can sit outside. There are two dining rooms for people to use. Troutbeck Care Home DS0000071045.V371852.R01.S.doc Version 5.2 Page 17 People said their rooms were always clean, and comfortable, they liked them and they have been decorated and furnished to their personal interests and tastes. All the bedrooms are en-suite and three have their own lounge areas. Many have views of the local area. To help prevent the spread of infections and to make the home a clean and comfortable place to live there is a cleaner and Anti-Bac soap despensers are installed at wash-points and aprons and glove are avialable for staff to use staff are instructed to adhere to the infection control policies and procedures. One person commented upon the effectiveness of the laundry. The home has a five star quality rating from the environmental health for their kitchen facilities. Troutbeck Care Home DS0000071045.V371852.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27, 28, 29 and 30. People who use the service experience Good quality outcomes in this area. Staff in the home are trained, skilled and in sufficient numbers to support people who use the service. People are protected by the home’s recruitment procedures. We have made this judgement using a range of evidence, including a visit to this service EVIDENCE: People told us staff do treat them well, and provide them with the support they need. They made positive comments about the staff such as: ‘staff look after them well and are very supportive.’ ‘the staff were generally helpful kind and displayed warmth.’ People living in the home said that they were generally enough staff available to meet their needs unless people were off work due to unexpected illness and their call bells were responded to. Staff also confirmed this, and that there was enough staff available to make sure people could access the activities they choose. During the visit we saw that staff had the time to sit and talk to people, also the staff rotas show that there is normally up to two registered nurses and eleven care staff on during the day for and eight care staff and two Registered Nurses on a evening for up to fifty four people. Troutbeck Care Home DS0000071045.V371852.R01.S.doc Version 5.2 Page 19 We talked to three staff who were are clear about their role, knew what is expected from them and showed a good understanding of the actions they needed to take to meet people’s needs in the way they prefer and need. We looked at three staff records and these showed us the home are requesting and receiving all the information necessary to make sure they are employing only suitable people for the job. We talked to the registered manager and a member of staff who had recently started work at the home and both told us that a induction programme in place that ensures new staff are given the right information to be able to do their jobs well. The home use a computer database which helps them to identify whether staff have completed and updated the necessary training to enable them to care for people safely and properly. We looked at the records from the database and these confirmed staff are provided with the training they need. Staff also told us about other specialist training they have received for instance peg feeding, mental capacity act and catheter care. The annual quality assessment questionnaire states over half of the staff have their National Vocational Qualification level two or above in care. This qualification helps to make sure staff are properly trained to carry out the work. Staff confirmed they have regular meetings. The records show these are used as a opportunity to recap policies and to make sure staff are kept up to date and able to carry out their roles properly. The registered manager has put into place a new system to make sure staff are receiving regular supervision and appraisals. Staff told us they do feel supported by the management. Troutbeck Care Home DS0000071045.V371852.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 31, 33, 35 and 38. People who use the service experience Excellent quality outcomes in this area. People benefit from a home that is managed in their best interests. We have made this judgement using a range of evidence, including a visit to this service EVIDENCE: The registered manager has worked for the provider for three years is a registered general nurse and has their National Vocational Qualification in Management. During the visit people were seen to be comfortable when approaching her to discuss the home, she always listened and responded with warmth and respect. Staff said they felt extremely well supported by the registered manager. The home is part of the Maria Mallaband group and there Troutbeck Care Home DS0000071045.V371852.R01.S.doc Version 5.2 Page 21 is a clearly defined management structure within the company, which supports the manager and staff in fulfilling the home objectives. The quality outcomes we have found during this inspection show that the home is managed in the best interests of the people who live there The AQAA contains, clear, relevant information and this is supported by a range of evidence. The data section of the AQAA is accurately and fully completed. Quality assurance systems consisted of an annual survey for people in the home to complete, regular residents meetings, care reviews, and reviews of the complaints and accidents records to identify any patterns etc. The home has also recently commenced the application for the investors in people award. The results of the August 2007 survey were available in the home and showed a high level of satisfaction with the services provided. The area manager visits the home regularly and audits various aspects of the service, progress reports are sent regularly to the CSCI. The Registered Manager told us about how she has organised staff supervisions to make sure they are carried out on time. Staff confirmed they receive regular supervision. The administrator explained the home holds a small amount of spending money for some people, this is held securely, all transactions are recorded and receipts are kept. The annual quality assessment questionnaire states the maintenance and service records are in order. The registered manager explained the their is a maintenance man who is responsible for carrying out all the regular health and safety checks. Accidents are recorded and reviewed by the registered manager to identify and resolve any potential risks. Troutbeck Care Home DS0000071045.V371852.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 4 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 4 17 X 18 4 4 X X X X X X 4 STAFFING Standard No Score 27 4 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 4 X 3 X X 4 Troutbeck Care Home DS0000071045.V371852.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No 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 Troutbeck Care Home DS0000071045.V371852.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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 Troutbeck Care Home DS0000071045.V371852.R01.S.doc Version 5.2 Page 25 - 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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