Care Home: Willow Bank House

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What the care home does well Buckland Care Ltd. and Ms. Dudley have recently satisfied the Commission that they are fit to run the service at Willow Bank House. Their combined efforts have already resulted in actions that result in better care for residents. People who use the service enjoy accommodation that was specifically designed and built to suit the needs of older people. The premises, essential services and equipment are being maintained well to be sure residents are safe and comfortable. Relatives have confidence in the staff and feel they do improve the quality of life for the people who use the service-`thank you for making the quality of life so good in the last few months`. Residents are supported in managing their own medication if they wish to do this. The staff handle other residents` medication well and keep accurate records of this work. Food hygiene arrangements are very effective. What has improved since the last inspection? The accommodation and facilities have improved through strengthened fire safety arrangements, additional specialist aids and equipment to help staff work safely with residents, and the appointment of a maintenance worker who can deal promptly with general repair and maintenance work. The working day for staff has been adjusted so that they are more available at times of the day that suit resident lifestyles. The way that staff are supported, supervised and trained has been developed to be sure they will be able to respond well to residents` care needs and expectations. Each person who uses the service has their care needs and their preferences more carefully monitored and recorded so that they will receive the support they need in a way that suits their wishes. CARE HOMES FOR OLDER PEOPLE Willow Bank House Tilesford Park Throckmorton Pershore Worcestershire WR10 2LA Lead Inspector Wendy Barrett Unannounced Inspection 12th February 2008 09:30 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 Willow Bank House DS0000070428.V359783.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. Willow Bank House DS0000070428.V359783.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Willow Bank House Address Tilesford Park Throckmorton Pershore Worcestershire WR10 2LA 01386 556 844 01386 556 744 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) Buckland Care Ltd Cheryl Anne Dudley Care Home 35 Category(ies) of Dementia - over 65 years of age (10), Old age, registration, with number not falling within any other category (35), of places Physical disability over 65 years of age (10) Willow Bank House DS0000070428.V359783.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service: Care Home only - Code PC to service user 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 OP 35 Dementia over the age of 65 (DE)(E) 10 Physical Disability over the age of 65 (PD)(E) 10 The maximum number of service users to be accommodated is 35. 2. Date of last inspection Brief Description of the Service: Willow Bank House is situated in a semi rural area on the outskirts of the village of Throckmorton and near to the town of Pershore. There is a bus service 3 times a week approximately 4 times a day that comes right up to the entrance to the home. It is also possible to request this convenient drop off at other times of the week. The home is purpose built, with ensuite accommodation on two floors and two passenger lifts providing level access throughout. There are communal lounges, a dining room and bathrooms and toilets with moving and handling equipment. Attractive level gardens are accessible for the residents to use. The home provides personal care for 35 people of either sex over the age of 65 years, 10 of who may have physical or mental health concerns. Buckland Care Limited was registered as the new owner of the service in October 2007. Ms. Linda Pownell was approved as the company representative who will maintain regular contact with Willow Bank House. She is required to undertake an unannounced visit to the home at least once a month and to submit a report of her findings to the company and to the Care Manager. Ms.Cheryl Dudley was registered as the new Care Manager of the service in August 2007. Willow Bank House DS0000070428.V359783.R01.S.doc Version 5.2 Page 5 Each resident receives a copy of the home’s Statement of Purpose and Service User Guide. This is large print and has been updated to reflect the new ownership and care management arrangements. Enquirers are also invited to read a copy at the home. Fees at the time of this inspection ranged from £353-00p. to £500-00p. per week. Additional charges are made for newspapers, toiletries, telephone, transport, wheelchair hire, hairdressing, dry cleaning and chiropody. Willow Bank House DS0000070428.V359783.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This was the first inspection of the service since the new ownership and care management registrations were approved. Ms. Dudley completed an annual quality assurance assessment (AQAA) prior to the inspection visit and at the request of the Commission. An unannounced inspection visit was undertaken. Examples of recent written feedback received at the home from residents, relatives etc. was referenced on this occasion instead of conducting a Commission-led survey exercise. Information held by the Commission about the service operation since the new provider registration was also used to inform this report. What the service does well: Buckland Care Ltd. and Ms. Dudley have recently satisfied the Commission that they are fit to run the service at Willow Bank House. Their combined efforts have already resulted in actions that result in better care for residents. People who use the service enjoy accommodation that was specifically designed and built to suit the needs of older people. The premises, essential services and equipment are being maintained well to be sure residents are safe and comfortable. Relatives have confidence in the staff and feel they do improve the quality of life for the people who use the service-‘thank you for making the quality of life so good in the last few months’. Residents are supported in managing their own medication if they wish to do this. The staff handle other residents’ medication well and keep accurate records of this work. Food hygiene arrangements are very effective. Willow Bank House DS0000070428.V359783.R01.S.doc Version 5.2 Page 7 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. Willow Bank House DS0000070428.V359783.R01.S.doc Version 5.2 Page 8 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 Willow Bank House DS0000070428.V359783.R01.S.doc Version 5.2 Page 9 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): 1,2 and 3. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Admissions are only agreed once Ms. Dudley has obtained enough information to be satisfied the home will be able to meet the potential residents’ needs. There is information literature available at the home to help people decide if the home will suit them. This explains clearly what service they can expect to receive and how much this will cost. EVIDENCE: Ms. Dudley always goes out to meet prospective residents in their own home so that she can find out what type of care they need and expect from Willow Bank House. This exercise helps her to decide if the staff will be able to meet the identified care needs and it gives the prospective resident an opportunity to ask questions about the home so they can get an idea if the home will meet their expectations. A married couple had recently been admitted and the husband explained how he was very pleased that they had an opportunity to Willow Bank House DS0000070428.V359783.R01.S.doc Version 5.2 Page 10 request separate bedrooms, and have this request met. Ms. Dudley keeps written records of her pre-admission findings so that the staff at the home can get to know about new residents before they actually arrive. New residents get a copy of the home’s Statement of Purpose and Service User guide so that they have essential information e.g. how to make a complaint, exactly what services the fees cover and what will be charged as an ‘extra’. A signed contract is also issued to clarify the specific arrangements for each individual e.g. which bedroom they have agreed to occupy. Willow Bank House DS0000070428.V359783.R01.S.doc Version 5.2 Page 11 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): 7,8,9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents’ care needs are met with the help of written plans of care and by staff who take note of all aspects of the residents’ wellbeing and choices. The care plans have improved recently although Ms. Dudley plans to develop them further so they are even more ‘person centred’. There has been an improvement in the supply of aids and equipment to help staff work safely with the residents. Residents are encouraged and supported to manage their own medication if they are safe to do so. When the staff administer medication they receive the training they need to do this safely and in line with satisfactory policies and procedures at the home. EVIDENCE: Ms. Dudley has recognised that the way the care is planned for each resident needs to be better designed to suit the individual. This is called a ‘person centred approach’ and it is good because it makes it really clear what type of Willow Bank House DS0000070428.V359783.R01.S.doc Version 5.2 Page 12 skills and knowledge a staff group need to look after each resident e.g. if a resident has a specific medical condition like Parkinson’s then the staff need to understand the condition and how they can best deal with its effects so the resident gets the best possible care. Ms. Dudley already encourages consultation with the resident or their representative in writing and reviewing plans because this is the best way to be sure the plan reflects the resident’s individuality. The Deputy Manager felt that the written records of care had improved considerably already –‘they are a lot better-more information in them’, so there is already evidence of good progress. The staff were observed in their handover meeting between shifts. The information they were sharing demonstrated satisfactory attention to all aspects of the residents’ wellbeing. There were examples of consultation with medical staff when staff noticed a change in a resident’s physical health, changes in mood and emotional wellbeing noticed e.g. a resident had been a little restless during the morning. Contact with relatives in planning the readmission of a resident from hospital was also reported during the handover meeting. Ms. Dudley refers to improved supplies of things like ramps, handling equipment, lifts, reclining chairs, feeding aids, sensory impairment aids since the new owners took over. A staff member was pleased with a new ‘standaid’ that helps the staff work safely when helping frail residents stand up. The home gets its medication supplies from Boots pharmacy. The company pharmacist had conducted an extensive audit at the home the week prior to this inspection visit. The outcome indicated a very satisfactory situation with only one recommendation to keep a record of the frequency of medication fridge cleaning. This is commendable because the pharmacist looked carefully at each resident’s medication regime and at the written guidance given to staff in the home’s policy and procedures. Ms. Dudley also arranges regular internal audits of medication so that any minor discrepancies can be quickly picked up and dealt with. There was a record seen of an audit undertaken in January ’08. A small sample of medication stock and records was inspected during this visit and was satisfactory. This included the arrangements for supporting a resident who preferred to administer her own medication. She had a lockable drawer in her bedroom to keep the medication safe and the staff were helping her maintain a supply while at the same time keeping an eye on any changes that could indicate a need to review the safety of the arrangement. One resident was an insulin dependent diabetic. It is acceptable for care staff to give insulin as long as they have been properly trained by a qualified nurse. Ms. Dudley was able to produce records to confirm that specific staff had, indeed, received training from a named nurse in respect of the particular resident’s insulin. Guidance about the possible effects of too much or too little insulin was also posted up in the kitchen and in the staff room. Willow Bank House DS0000070428.V359783.R01.S.doc Version 5.2 Page 13 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): 12,13,14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service receive support from the staff so they can enjoy their days as they wish. Relatives are welcomed into the home and encouraged to participate in any activities. A choice of meals is offered so that everyone can enjoy their food, and the staff keep an eye on each resident’s nutritional needs so that residents get a suitably well balanced diet. EVIDENCE: There is a regular programme of social activities at the home. This includes events in the home and some out in the local community. The staff encourage relatives to participate more fully in this aspect of the service so there can be more variety of opportunities e.g. trips out. Regular meetings and coffee mornings have been introduced as a way of getting residents and relatives more involved. A relative commented in a thank you card sent to staff- ‘‘we all appreciated the hospitality shown to us as a family when we visited’. Willow Bank House DS0000070428.V359783.R01.S.doc Version 5.2 Page 14 Two main meals are prepared each day so that people who use the service have a choice of menu, and the staff keep an eye on each resident’s diet by assessing any special nutritional needs as part of their everyday care. A resident who was interviewed during the inspection visit confirmed that ‘the food is good’. Willow Bank House DS0000070428.V359783.R01.S.doc Version 5.2 Page 15 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): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service know how to make a complaint about the service and when this happens the concerns are looked into and action taken to put things right. The home protects people from abuse by making sure all staff understand about adult protection. This would be strengthened with a better awareness of the local arrangements for investigating any allegations. EVIDENCE: The Commission has received one complaint about the service since the registration of the new owners. The complainant agreed to pursue the concerns directly with the home in the first instance. She later confirmed to the Commission that the problem had been sorted out to her satisfaction by Ms. Dudley. When concerns are raised at the home Ms. Dudley keeps a record of the relevant details. These records showed that the home’s complaints procedure is being properly followed to be sure that people get a prompt response in writing. All people who use the service have a copy of the procedure and it is also displayed in the home. The Deputy Manager explained how all new staff receive guidance to help them recognise and report situations that may indicate a resident is at risk of abuse. They have written information at the home to help them with this important aspect of their work. This is kept up to date e.g. a whistle blowing policy was Willow Bank House DS0000070428.V359783.R01.S.doc Version 5.2 Page 16 updated in December 2007. Ms. Dudley plans to spend more time training staff in abuse issues. It would be a good idea to make sure all staff understand about the local multi-agency protocols for safeguarding adults. They don’t yet have a clear awareness of this protocol and how to make use of it although they showed an overall good understanding and commitment to protecting the residents in their care. Willow Bank House DS0000070428.V359783.R01.S.doc Version 5.2 Page 17 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): 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People live in a home that has been designed and built with the needs of older people in mind. It is kept in good condition through a routine programme of servicing and refurbishment and is equipped with the right specialist equipment for promoting independence. Residents feel their bedrooms are comfortable and that they are encouraged to make their room homely. The staff work in a hygienic way so that the environment is clean and safe. EVIDENCE: Willow Bank House is a purpose built home with en-suite accommodation on 2 floors. There are two passenger lifts and accessible gardens so that people with problems walking can still get around easily. Buckland Care Ltd. are proposing to extend the accommodation in the coming year and this will Willow Bank House DS0000070428.V359783.R01.S.doc Version 5.2 Page 18 improve the facilities for everyone. This may be a good time to have a hand washbasin fitted in the bathroom that currently doesn’t have this facility. Staff have suitable aids and equipment to help them work safely with the residents. The Deputy Manager mentioned how pleased she was that the new owner had purchased an additional piece of equipment called a Standaid. This is a mechanical tool that supports residents in standing themselves upright from a sitting position. People who use the service can bring in some of their own furniture to make themselves feel ‘at home’ in their bedroom. One resident had done this and was very pleased with her accommodation. She also had a television, large numbered telephone and a large faced bedside clock in her room and spent quite a lot of the day in her bedroom. The home offers several communal areas where residents can sit together and share activities if they so wish. These are light, airy and well furnished rooms with toilet facilities comfortably nearby. Ms. Dudley has been improving the environment so that it has a ‘homely’ appearance. There is a maintenance man employed to deal with everyday repairs etc., and essential equipment and services are regularly serviced by outside contractors e.g. passenger lifts, hoists. The staff follow procedures to be sure they work hygienically. This approach no doubt contributed considerably to the home receiving a commendation from Wychaven District Council in January 2008 for food hygiene arrangements. A certificate described the situation as ‘very good’. Willow Bank House DS0000070428.V359783.R01.S.doc Version 5.2 Page 19 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): 27,28,29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are enough staff and their working hours are arranged to suit the residents’ needs. New staff are carefully selected to be sure they will be safe to work alongside vulnerable adults and all staff are given the support, guidance and training they need to work effectively with the people who use the service. EVIDENCE: The day and night staff rotas are arranged to make sure there is always a competent senior staff member on duty in the home. A team of care assistants supports the senior. Comments from people who use the service and their relatives indicate that there are enough staff to meet the residents’ care needs-‘thank you for making the quality of life so good in the last few months’ (comment made in January 2008). Separate staff are employed to clean, cook and launder clothes, and a part time maintenance man has recently joined the team of support staff. The time that day staff start work has been moved forwards an hour to 8am. This encourages a relaxed start to the day for residents and also means that day staff are on duty an hour later to help residents enjoy the evening period. When new staff are recruited the applicants are checked in line with national requirements e.g. criminal records bureau checks are made. Two staff files Willow Bank House DS0000070428.V359783.R01.S.doc Version 5.2 Page 20 contained the relevant documents to show that these checks had been completed and Ms. Dudley only appoints applicants who can demonstrate they are suitable to work alongside vulnerable adults. Once recruited, new staff have induction training to help them settle into their new job and to understand how they should behave to protect the residents’ rights, dignity, privacy and safety. Staff files included records of induction programmes. The current programme used is in line with national specifications. All staff are being encouraged to obtain a relevant national vocational qualification and there is already a good percentage (68 ) of care staff who have either obtained, or are working towards this award. A staff member referred to a programme of health and safety training-‘the training is good, always something being provided’. She gave examples of this –fire drills arranged for February and March, 3 dates for first aid training, including one for night staff. The staff member had received refresher manual handling training just before Christmas and was aware of another session due soon. Ms. Dudley has plans to include dementia care as a mandatory training and would like to increase the amount of professional care practice instruction e.g. more attention to specific conditions that residents may have, such as diabetes. The Deputy Manager will be helping Ms. Dudley to maintain a regular programme of meetings with individual staff to discuss their work performance and professional development. This will happen once Ms. Dudley has completed a programme of staff appraisal exercises that is already underway. There are regular staff meetings at the home. Willow Bank House DS0000070428.V359783.R01.S.doc Version 5.2 Page 21 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): 31,33,35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management team have the necessary knowledge and experience to make sure the people who use the service receive the right support. The procedures followed by staff are regularly monitored and reviewed and feedback from involved partied is being encouraged so that the quality of the service can be assured. There is an open approach so that any shortfalls can be identified, acknowledged and plans put into place to address them. This attitude strengthens the safety and comfort of the vulnerable people who receive a service. EVIDENCE: Willow Bank House DS0000070428.V359783.R01.S.doc Version 5.2 Page 22 The Commission in October 2007 approved the new owner of Willow Bank House. This means the company satisfied the Commission it was capable of running a personal care home business. Ms. Dudley is also registered with the Commission as a suitable person to manage everyday care. She has already obtained a Registered Manager’s Award that is a recognised qualification for Care Managers. At the time of this inspection she had not quite completed a national vocational qualification in care at level 4. Once this has been completed she will fully meet the standard required. An administrator has been recruited to support Ms. Dudley. The annual quality assurance assessment report (AQAA) that was filled in by Ms. Dudley before the inspection visit demonstrated a good awareness of the legal requirements and the good practice guidelines for managing care homes. It also shows how Ms. Dudley is able to identify aspects of the service that need more attention and how she intends to do this e.g. more staff training that relates to the particular care needs of the residents. There is a quality assurance system implemented at the home that helps Buckland Care Ltd. and Ms. Dudley monitor whether the service is satisfying the people who use it. Part of this system involves sending out questionnaires to residents, staff and relatives and an exercise was actually underway at the time of this inspection. The written guidance provided for staff e.g. policies and procedures, is regularly reviewed to make sure it reflects up to date legislation and good practice guidance e.g. a health and safety policy had been reviewed in December 2007. A representative of the company visits the home at least once a month on an unannounced basis. During these visits there are random checks on records etc. and residents, relatives and visitors are invited to chat about their experience of the service. Reports of these visits were available, as required by the Commission. They may be improved if the names of people consulted on each visit were entered into the report because this could show how the Provider representative tries to meet as many different people as possible during her programme of visits. Ms. Dudley appropriately encourages residents to ask relatives to help them with financial matters, but the home has satisfactory arrangements for keeping personal money in safekeeping when this is unavoidable. Storage is secure and records are maintained of individual transactions. This report includes reference to the work done by managers and staff to make sure the people who use the service live in a safe and healthy environment. The premises are subject to regular maintenance checks. A Letter from a Fire Safety Officer confirmed that an audit of fire safety arrangements undertaken the week before this inspection visit had resulted in a very positive report. The Fire Officer was completely satisfied and did not need to make any new requirements. There was evidence of recent checks of portable electrical appliances throughout the home in order to make sure they were all safe for residents and staff use. The staff receive regular training in safe working practices. Willow Bank House DS0000070428.V359783.R01.S.doc Version 5.2 Page 23 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 3 3 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 4 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 3 17 x 18 2 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 3 Willow Bank House DS0000070428.V359783.R01.S.doc Version 5.2 Page 24 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. 1. 2. Refer to Standard OP18 OP19 Good Practice Recommendations All staff should be familiarised with the local arrangements for safeguarding adults. A hand washbasin should be fitted in the bathroom that currently doesn’t have this facility. Willow Bank House DS0000070428.V359783.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection West Midlands West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway Birmingham, B1 2DT 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 Willow Bank House DS0000070428.V359783.R01.S.doc Version 5.2 Page 26 - 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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