Inspection on 25/02/08 for 6 High Beech Close

This is the latest available inspection report for this service, carried out on 25th February 2008.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

6 High Beech Close 30/11/05

6 High Beech Close 15/06/05

6 High Beech Close 28/02/05

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Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 6 High Beech Close St Leonards-On-Sea East Sussex TN37 7TT Lead Inspector Niki Palmer Unannounced Inspection 25th February 2008 13:45p 6 Highbeech Close DS0000061409.V357976.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address 6 Highbeech Close DS0000061409.V357976.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. 6 Highbeech Close DS0000061409.V357976.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 6 High Beech Close Address St Leonards-On-Sea East Sussex TN37 7TT 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) 01424 852464 01424 854376 sfisher.evh@tiscali.co.uk www.eastviewhousing.co.uk East View Housing Management Ltd Sharon Kathleen Fisher Care Home 3 Category(ies) of Learning disability (0) registration, with number of places 6 Highbeech Close DS0000061409.V357976.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home only - (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 Disabilities The maximum number of service users to be accommodated is 3. Date of last inspection 19th September 2006 Brief Description of the Service: 6 High Beech Close is a care home, which provides personal care and accommodation for up to three people with mild to moderate learning disabilities. The home is owned and run by East View Housing Limited (EVH), who also own 12 other care homes for people with learning disabilities in the St Leonards and Hastings area. EVH have been providing support to people with learning disabilities in small group homes since 1989. The home is a detached property located in a quiet cul-de-sac. It is a modern style house with four bedrooms, the smallest of them being an office and staff sleep-in room. One bedroom has en-suite facilities, whilst the two other bedrooms share a family size bathroom on the same floor. A separate cloakroom is located on the ground floor. The home has a domestic kitchen, utility room, dining area and good-sized lounge. Residents have use of a well-maintained rear garden. The home has access to it’s own driveway and garage. Some parking facilities are available. The home provides personal care and support to residents who are funded/part funded by Social Services. The home’s fees as of the day of inspection ranged from £766 - £1049 per week. As not all monies are covered by Social Services, residents are expected to pay a monthly ‘top up’ fee. A copy of the home’s most recent inspection report is available on request from the home. 6 Highbeech Close DS0000061409.V357976.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 2 stars. This means the people who use this service experience good quality outcomes. The reader should be aware that the Care Standards Act 2000 and Care Homes Regulation Act 2001, uses the term ‘service user’ to describe those living in care home settings. For the purpose of this report, those living at 6 High Beech Close will be referred to as ‘residents’. This unannounced inspection took place on Monday 25th February 2008 and lasted nearly six hours. This enabled to Inspector to observe the afternoon and evening routine of the home when all residents were at home. Three female residents were accommodated on the day of the inspection, aged between 21 and 41 years of age. The Inspector had the opportunity to meet with all members of staff including the Registered Manager at the beginning of the inspection as the team were having their monthly staff meeting. This was followed by discussions with the Manager, in respect of progress made since the last inspection and informal discussions with staff and residents in the lounge/dining area. One of the residents kindly showed the Inspector around the home. One bedroom and all communal areas were seen. One person’s care records were examined in some detail for the purpose of monitoring care. Other areas and documents looked at included: the home’s Statement of Purpose, medication procedures, complaints procedure and the systems in place to safeguard people from harm, staff recruitment checks and the provision of training, the home’s quality assurance systems and some health and safety records. An Annual Quality Assurance Assessment (AQAA) was completed by the Registered Manager and returned to the CSCI prior to the inspection. This gave the service the opportunity to say what the service does well, identify any barriers to improvements that have been faced over the past 12 months and how the service plans to make improvements within the next 12 months. A number of their comments have been reflected throughout this report. 6 Highbeech Close DS0000061409.V357976.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? Four requirements were made at the last inspection, all of which have been met: A number of areas throughout the home have been redecorated. 6 High Beech Close now presents as a well-maintained and homely place to live. The home is kept free from offensive smells. This is because the pet rabbit has moved on to pastures new. Mrs Fisher was successful in her application to become the Registered Manager of the home. All health and safety records are now kept at the home and are available for inspection. 6 Highbeech Close DS0000061409.V357976.R01.S.doc Version 5.2 Page 7 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. 6 Highbeech Close DS0000061409.V357976.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection 6 Highbeech Close DS0000061409.V357976.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 and 4. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has good systems in place to make sure that no person moves into the home whose needs cannot be met. Prospective residents can visit the home and get full, clear, accurate and up to date information about whether the home can meet their needs and aspirations. EVIDENCE: Whilst the home’s Statement of Purpose and Service Users’ Guide were not inspected in detail on the day of inspection, the Manager explained to staff during the team meeting that the Statement of Purpose has very recently been updated. A copy of this was provided to the CSCI. It provides the reader with details of the organisational structure of the home, staffing details and their relevant training qualifications and other key information in respect of what people can expect from the home. The Manager explained that as much information as possible is gathered prior to any new person moving into the home. This is the responsibility of the Manager and in some cases, other senior managers of EVH. One person has moved into the home since the last inspection, although is soon to move to more independent supported living. Care records showed that a good level of information was gathered prior to admission to make sure that their needs 6 Highbeech Close DS0000061409.V357976.R01.S.doc Version 5.2 Page 10 could be met. This was done in consultation with the person’s previous place of residence and health and social care professionals. The Manager informed care staff during the team meeting of a potential new resident. It was explained that the person would visit the home informally over a number of weeks in order to get know the other residents and staff and to determine whether or not the home would be suited to their needs. The Manager said that she has already met with the person and their relatives and has begun the assessment process. 6 Highbeech Close DS0000061409.V357976.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff have a good understanding of residents’ needs, however both residents and staff would benefit from a clearer, person centred approach to care planning. EVIDENCE: The home uses a number of different care records and recording methods for each person (11 in total): a life book, general file, health file and separate Health Action Plan, food diary, risk assessment file, medication file, positive interaction profile, a wishes wants and needs list, individual 1-1 discussions book and a day to day file. It was therefore not easy for the Inspector (or for a person who is unfamiliar with working with each person) to get a clear overview of individual needs. Residents also commented that they were not sure what each file was for (although they understood that they contained personal information about them). Whilst the staff team is very small and through discussions with them it was clear that they do have a good understanding of individual needs, it is strongly recommended that the number 6 Highbeech Close DS0000061409.V357976.R01.S.doc Version 5.2 Page 12 of different care records being used be reviewed and simplified. This will help to make sure that the home’s care planning procedures are in line with person centred planning and that the care plan can be easily used by the individual and care staff who are not familiar with the person. Residents told the Inspector about their personal goals, wishes and aspirations. For one person it is important for them to build on independence skills such as telling the time, reading and writing and learning to take control of their medication. Whilst these were outlined in individual care records, discussions with staff suggested that more could be done on an individual basis to support each person in achieving these e.g. by breaking down each goal into a smaller achievable tasks (using talking clocks to learn to tell the time, or by using an alarm clock / watch as a reminder to take their medication). The home’s AQAA stated: “Our residents are encouraged to make their own choices and where these choices may not be realistic we offer support to identify ways of adapting them to a more realistic choice without taking away the main part of the original choice”. Residents talked openly with the Inspector about how the staff team support them to make individual choices and decisions. They said that are given the choice of activities that they wish to take part in (or not), what food they would like to buy and eat and where they would like to go on holiday and who with. They explained that that they are kept informed about any changes within the home that may affect them through regular house meetings. Whilst all residents have individual risk assessments in place for most activities of daily living, the home should consider ways in which residents can be supported to take more responsible risks in order to promote their independence e.g. by having access to some ‘safer’ cleaning materials that would enable them help with tasks in the home, become more involved in the preparation of food, take more responsibility for their medication and look after their own monies. 6 Highbeech Close DS0000061409.V357976.R01.S.doc Version 5.2 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): 11, 12, 13, 14, 15, 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are involved in meaningful daytime activities of their own choice and according to their individual interests. They are supported to maintain positive relationships with family and friends. EVIDENCE: EVH owns and manages a day centre called Reilley House, which is accessed by some residents from this home and others living within EVH homes Monday to Friday (although not all people choose to go each day). Residents said that they can join in activities such as trampolining, swimming, cooking, arts and crafts, jewellery making and dance and music. Other day care centres are also used, which provide residents with opportunities to take part in skills building workshops. One person told the Inspector that her key worker helped her to find voluntary work at a local school for children with learning disabilities. She said that she 6 Highbeech Close DS0000061409.V357976.R01.S.doc Version 5.2 Page 14 is hoping to use this experience to work towards achieving an NVQ certificate and potentially paid employment in the future. Residents said that evenings and weekends are flexible and relaxed. On the evening of this inspection a masseuse visited the home, whilst a relative arrived later on in the evening. Whilst all residents have their own TV and music equipment in their own rooms, they did say that they often quite like to sit in the main lounge area together with staff to watch their favourite programmes in the evenings. Different community activities that residents take part in include going into town, using the local park, swimming pool, pubs and shops. Residents said that they also use local events organised specifically for people with learning disabilities. Residents did say that they would also like to try local nightclubs and other events (not for people with learning disabilities). Residents told the Inspector about their most recent holiday to Butlins in Bognor Regis and their forthcoming holiday to Blackpool in May. All three residents will be going together with support from two care staff. The home has a cat, which residents are encouraged and supported to look after. Residents said that they are supported well by staff to maintain contact with friends and relatives. Two residents have their own mobile phones. One person chooses stays with her relatives some weekends. The home does not have access to it’s own transport, although all residents do have their own bus passes. Two people can use public transport independently, although taxis are sometimes used. The Manager said that weekly menus and evening meals are supposed to be planned at the weekend, based on individual choices and that from these, residents and staff purchase the food from local supermarkets. The most recent menu that was displayed in the kitchen was dated December 2007 although residents did say that they are given the choice of what they would like to eat each day (mostly from what is available within the home and in the freezer). Residents said that they sometimes help with food preparation, although this is mostly undertaken by staff (due to health and safety aspects in the kitchen). The home should consider different ways in which residents can be supported and encouraged to take part in the preparation of food. 6 Highbeech Close DS0000061409.V357976.R01.S.doc Version 5.2 Page 15 All residents and staff were observed to eat the evening meal together in the dining area on the day of inspection. One person helped to clear away and tidy the kitchen afterwards. 6 Highbeech Close DS0000061409.V357976.R01.S.doc Version 5.2 Page 16 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents receive personal support from staff in the way they prefer and want and are supported to access a range of healthcare services to meet their individual needs. Residents are safeguarded by the home’s policies and procedures for the safe administration of medicines. EVIDENCE: All three residents are fairly independent and therefore require minimal assistance with personal care. Residents did say that staff are always on hand to help if needed. As all three residents are female, only female members of staff are employed to work in this home. All residents are registered with their own choice of GP and dentist and are supported to all healthcare appointments as necessary. Clear records of all healthcare appointments are kept. Input from the local Community Learning Disability Team (CLDT) is requested as necessary. Recent requests for referrals have included support from a Clinical Psychologist and Consultant Psychiatrist. 6 Highbeech Close DS0000061409.V357976.R01.S.doc Version 5.2 Page 17 The home’s medication records and storage systems were seen. The home uses pre-packed blister packs issued by the local pharmacy, which are easy to use and monitor. Staff confirmed that they received medication training during their induction period to the home and are reassessed yearly by the Registered Manager of the service. Only two residents are currently prescribed any medicines. All staff are responsible for reordering and checking medicines into and out of the home. One Resident said that she is able to self-administer one of her tablets, although she requires verbal reminders from staff (as she has difficulty in knowing when she needs to take it). When this was discussed further with staff, it became apparent that because of an incident that occurred some years ago (whereby a tablet was dropped down the sink) she has to take her medicines in front of staff in the office. The staff team should consider different ways in which they can support residents to manage their own medicines. This should of course be based on individual risk assessments. 6 Highbeech Close DS0000061409.V357976.R01.S.doc Version 5.2 Page 18 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can be assured that the home will listen to and act upon any concerns or complaints they may have. The home safeguards residents from abuse, neglect and harm and takes action to follow up any allegations. Residents’ financial interests are safeguarded. EVIDENCE: All residents spoken with said that they would feel confident in raising any concerns or complaints they may have directly with their key worker or with the Manager of the home. It was explained that the home regularly seeks their feedback on any issues that may arise through regular house meetings and 1-1 key worker meetings. One person said that her key worker had acted very quickly when she complained about one of her day services and expressed a wish to find an alternative. She said that as a result of this, voluntary work was found for her instead. There have been no formal complaints received by either the home or the CSCI since the last inspection. The Inspector requested a copy of the home’s policies and procedures for safeguarding vulnerable adults from abuse. It was concerning to note that these were dated 2003 and state that the CSCI are the lead agency in safeguarding matters. These must be amended in line with revised multiagency guidelines produced June 2007 to state that Social Services are the lead agency. 6 Highbeech Close DS0000061409.V357976.R01.S.doc Version 5.2 Page 19 The Inspector asked a member of staff if the home has a copy of the revised multi-agency guidelines for safeguarding vulnerable adults from abuse. She said no, but that she was aware of them as they had recently been discussed as part of her NVQ training (although it must be noted that these were later found by the Manager of the service, but were not yet in use or been shared with staff). The member of staff spoken demonstrated a clear understanding of the different types of abuse and the actions that she would take in the event of suspecting and reporting potential abuse. The home has appropriately notified the local CLDT and CSCI of four safeguarding adults incidents since the last inspection. All residents have their own bank accounts, which they are supported to access by staff. Only one person at present looks after her money own money tin in her bedroom. Both others are kept locked in the office. Clear expenditure records are kept are regularly checked. Through discussions with staff, there appear to be no reasons as to why both other residents could not be supported to have more control over their monies also. This would help to empower residents and help them to work towards managing their own monies and budgeting skills as per their individual needs, wishes and personal goals. 6 Highbeech Close DS0000061409.V357976.R01.S.doc Version 5.2 Page 20 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 6 High Beech Close offers a friendly and relaxed environment that is kept in good decorative order. It presents as a clean, well-maintained and homely place to live. EVIDENCE: One of the residents kindly showed the Inspector around all communal areas in the home and one individual bedroom. Since the last inspection, a number of areas have been redecorated. This has improved the overall appearance of the home. It was noted however that carpets in some areas (by the doorway to the lounge and outside one of the resident’s bedrooms) had become frayed and posed as a trip hazard to residents and staff. This was pointed out to the Manager on the day of inspection and a requirement made. 6 Highbeech Close DS0000061409.V357976.R01.S.doc Version 5.2 Page 21 Concerns were raised at the last inspection in respect of a pet rabbit that was being looked after by one of the residents; its hutch was noted to be dirty and cause some areas of the home to smell. The Manager confirmed that since the last inspection the rabbit and resident who was responsible for looking after it have moved on to pastures new. All residents have their own bedrooms, which have been individually decorated. Residents said that they are responsible for keeping their rooms clean and tidy (although the current storage arrangements for cleaning materials, mean that residents have to ask a member of staff to unlock them for them from the kitchen cupboard). Communal facilities include a kitchen and utility area, lounge, separate dining area and a well-maintained garden to the rear of the property. Residents and staff explained that the home is currently in the process of having a new patio area laid, which they hope will be finished in time for the summer. Residents and staff said that EVH are very quick to mend and repair things within the home as required. 6 Highbeech Close DS0000061409.V357976.R01.S.doc Version 5.2 Page 22 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 and 36. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported by a consistent and well trained staff team who know each of the residents well. The staff team are supported to provide consistent care through regular supervision and staff meetings. EVIDENCE: The home employs three female care staff to offer support to the residents on a daily basis, although an additional member of staff is due to start work April 2008. Staff and rotas confirmed that weekday working hours are 4pm-10pm followed by a sleep-in duty and then 7am-9am the following morning. Some staff work additional hours when needed although in an emergency, agency staff may be used. The Manager and staff said that all job advertisements are advertised in local newspapers. All information is coordinated by Head Office who are responsible for sending out application forms, alongside the required police checks, health declaration and equal opportunities monitoring form. The recruitment records 6 Highbeech Close DS0000061409.V357976.R01.S.doc Version 5.2 Page 23 for one member of staff were requested. Whilst a detailed application form and two suitable written references were seen, the Inspector recommends that police check disclosure reference numbers are recorded within each person’s file including the date confirmation was received. This will help to satisfy the Manager and the CSCI that the organisation has followed robust recruitment practices. The Manager explained that she is involved in interviewing new staff, although stated in the AQAA that she is keen to get residents more involved in this process. The home’s progress with this will be followed up at the next inspection. Staff confirmed that EVH provides all new staff with a good induction to the organisation and the home that they are employed to work in. New staff initially work directly with and under the supervision of the Manager, which enables them the right time and support to complete their induction booklet, followed by ‘doubling up’ and ‘shadowing’ other more experienced members of staff. Staff said that this gives them a good opportunity to get to know each of the residents well before working alone. Staff said that EVH are a good employer and offer regular training courses for them to keep themselves up to date. The AQAA identified that two members of staff hold a Learning Disability Awards Framework (LDAF) certificate, whilst the third person is currently working towards this. One person holds an NVQ Level 2 certificate in Care and is working towards completing level 3; whilst the other two members of staff are due to begin working towards this qualification in the near future. This will be followed up at the next inspection. Staff confirmed that they receive regular supervision from the Manager. Records of these were seen on the day of inspection, although the contents were not read. 6 Highbeech Close DS0000061409.V357976.R01.S.doc Version 5.2 Page 24 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A skilled and experienced Manager provides clear direction and support to enable the staff to provide a high standard of care to residents. Both residents and staff benefit from a well managed and organised home. EVIDENCE: Mrs Fisher was successful in her application to become the Registered Manager of this service in June 2007. She is also registered as the Manager of two other small EVH services nearby. She has over six years experience in the care industry, all of which have been with EVH. She holds NVQ Level 4 in Management and has obtained a Registered Manager’s Award (RMA). She explained on the day of inspection that EVH are in the process of recruiting a Deputy Manager to help support her in her role. The home’s progress with this will be followed up at the next inspection. Feedback from staff and residents about her management style was very positive. 6 Highbeech Close DS0000061409.V357976.R01.S.doc Version 5.2 Page 25 The home has a good quality assurance system in place to monitor what they are doing and to identify areas of strength and areas that need improvement. The home’s AQAA stated that they do this through regular 1-1 meetings with residents, residents’ house meetings and feedback questionnaires from relatives and other health and social care professionals. The home’s AQAA was returned to the CSCI well before the date it was due. This is because the Manger had been working on it and updating it at regular intervals. It gave an accurate, open and honest account of how the service is performing. Feedback from residents indicated that they do feel the home is run in their best interests. Whilst most areas of the home were found to be safe and well-maintained, it was noted that door wedges were in use throughout. Through discussions with residents and staff, it emerged that some bedroom doors were being wedged open throughout the night, thus posing a potential fire risk to residents and staff. These concerns were raised with the Manager on the day of inspection, who removed them immediately. She also wrote to the CSCI the day after the inspection confirming that arrangements had already been made with senior managers of EVH to meet with a fire representative to discuss the most appropriate action. She agreed to keep the CSCI updated. As prompt action was taken, the CSCI considers the overall quality rating for this outcome area to be good. A small number of health and safety records including incident reports were seen during the inspection (in response to a requirement made at the last inspection, copies of all health and safety checks are now kept within the home and not at head office). These confirmed that all appliances and regular health and safety checks including fire-fighting equipment are frequently carried out and that staff are good at reporting any untoward incidents or accidents. One concern was raised however in respect of hot water temperatures; these were noted to vary between 42°C and 56°C, with one person’s shower delivering hot water at 52°C (above the recommended 43°C), yet there was no evidence to show that the member of staff responsible had reported this in order to get the temperature adjusted accordingly. A requirement has been made in respect of this. 6 Highbeech Close DS0000061409.V357976.R01.S.doc Version 5.2 Page 26 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 2 25 3 26 3 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 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 2 X 6 Highbeech Close DS0000061409.V357976.R01.S.doc Version 5.2 Page 27 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. 1. Standard YA23 Regulation 13(6) Requirement That the home’s policies and procedures for safeguarding vulnerable adults from harm, neglect and abuse are updated in line with revised multi-agency guidelines. These must state that Social Services are the lead agency. All staff must be aware of the revised procedures. 2. YA24 YA42 3. YA42 23(4)(a) 23(2)(b) That all carpeted areas throughout the home are kept safe and do not pose as a trip hazard to residents and staff. That following consultation with the fire authority, adequate precautions are taken to prevent residents and staff from the risk of fire. That the appropriate action is taken by care staff when any hot water outlets are found to be delivering hot water above the recommended 43°C. 31/03/08 Timescale for action 31/03/08 31/03/08 4. YA42 13(4) 31/03/08 6 Highbeech Close DS0000061409.V357976.R01.S.doc Version 5.2 Page 28 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. Refer to Standard YA6 Good Practice Recommendations That the number of different care records being used be reviewed and simplified. This will help to make sure that the home’s care planning procedures are in line with person centred planning and that the care plan can easily be used by the individual and care staff who are not familiar with the person. That the home considers different ways in which staff can empower residents and support them to learn independence skills such as: - Telling the time - Taking responsibility for their own medication - Becoming more involved in daily routines within the home e.g. cleaning and food preparation - Managing their own monies. That police check disclosure reference numbers are recorded within each staff member’s person’s file including the date confirmation was received. This will help to satisfy the Manager and the CSCI that the organisation has followed robust recruitment practices. 2. YA7 YA9 YA17 YA20 3. YA34 6 Highbeech Close DS0000061409.V357976.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 6 Highbeech Close DS0000061409.V357976.R01.S.doc Version 5.2 Page 30 - 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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