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Inspection on 30/04/08 for Argyle Road (Respite Care Project)

Also see our care home review for Argyle Road (Respite Care Project) for more information

This is the latest available inspection report for this service, carried out on 30th April 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 6 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Support residents to actively participate in life within and external to the home. The registered persons continue to work well with families and placement authorities in the best interests of residents.Generally a planned programme of training is in place that is service specific, which benefits both residents and staff. Residents are given opportunities to contribute to the development of the service. The organisation is also effective at promoting user involvement in the organisation and the wider community.

What has improved since the last inspection?

Risk assessments were in place for all residents, which were linked to their care plans. Evidence was in place to demonstrate how residents make choices regarding their meals including their pack lunches. Net curtains in the home were in a satisfactory condition. Appraisals have been carried out for staff. COSHH data sheets were reviewed and are now updated.

CARE HOME ADULTS 18-65 Argyle Road (Respite Care Project) 36 Argyle Road Ilford Essex IG1 3BQ Lead Inspector Stanley Phipps Unannounced Inspection 30 April - 13th May 2008 12:00 th Argyle Road (Respite Care Project) DS0000025885.V361280.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 Argyle Road (Respite Care Project) DS0000025885.V361280.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. Argyle Road (Respite Care Project) DS0000025885.V361280.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Argyle Road (Respite Care Project) Address 36 Argyle Road Ilford Essex IG1 3BQ 020 8518 3064 020 8518 3064 manager.argyle@rchl.org.uk www.rchl.org.uk Redbridge Community Housing Limited [RCHL] 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) None at Present Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Argyle Road (Respite Care Project) DS0000025885.V361280.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. To include (one) named person over 65 To include 1 (one) named individual with mental health problems. Date of last inspection 26th June 2006 Brief Description of the Service: The home forms part of the Argyle project and is a six-bed respite unit. The other houses in the project are two-bedded flats and four single self -contained flats in the local area. The house is situated near to Ilford town centre and is close to local facilities and transport networks. The property is owned by the London Borough of Redbridge and managed by Redbridge Community Housing Limited (RCHL). The aim of the home is to provide short stay accommodation for up to six adults with mild to moderate learning disabilities. The home has six single bedrooms, one of which is situated on the ground floor. The ground floor shower and toilet are accessible to wheelchair users. There is an accessible rear garden that is suitable for the size and needs of the service user group. A statement of purpose is made available to all service users in the home and a pictorial service user guide is complimented by a video about the home. This has been developed with the input of service users and staff. Given that the service is short stay (respite), service users quite like the idea of having the information in this format. Fees are charged at £13.50 per night, although this may depend on the level of benefit/s a person receives. Argyle Road (Respite Care Project) DS0000025885.V361280.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 star. This means the people who use this service experience good quality outcomes. The inspection was unannounced and was carried out over the period 30/4/08 through to the 13/05/07. At the time of the site visit the acting manager was available to provide evidence as part of the inspection process. This was because just prior to the visit the registered manager had resigned. There was one resident in the home at the time of the visit and due to feeling unwell, the individual was unable to actively make contributions to the inspection process was inhibited by, a feeling of ill health. However, all staff on duty did make made contributions to the process. Just prior to the inspection the responsible individual contacted the Commission to advise of: the interim managerial arrangements for the home and the organisation’s plan to review how the service at Argyle Road is being delivered. There was a commitment to keep the Commission informed of the plans as and when they are formalised. Towards the end of compiling this report the registered persons forwarded plans for the managerial arrangements for the home, which included reviewing the job description and recruiting a permanent manager. An assessment of medication practice, menus, policies and procedures, records required by regulation, residents’ care plans and the environment was undertaken. Discussions were held with the manager and several members of staff. Formal interviews were also held with one member of staff along with an informal chat with a relative. The inspector also observed a team meeting in progress. The inspection went on to consider: information provided in the Annual Quality Assurance Assessment (AQAA) provided by the registered person, verbal feedback from external professionals, along with comment cards that were returned from staff and residents. Generally residents are benefiting from a service that provides good quality care and support to its users. This is evidenced by the progress made to date since the last inspection. However, there are still areas for improvements that are identified in this report, which could once complied with – would take the home to another level. What the service does well: Support residents to actively participate in life within and external to the home. The registered persons continue to work well with families and placement authorities in the best interests of residents. Argyle Road (Respite Care Project) DS0000025885.V361280.R01.S.doc Version 5.2 Page 6 Generally a planned programme of training is in place that is service specific, which benefits both residents and staff. Residents are given opportunities to contribute to the development of the service. The organisation is also effective at promoting user involvement in the organisation and the wider community. 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. Argyle Road (Respite Care Project) DS0000025885.V361280.R01.S.doc Version 5.2 Page 7 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. Argyle Road (Respite Care Project) DS0000025885.V361280.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 Argyle Road (Respite Care Project) DS0000025885.V361280.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) People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. Residents continue to have access to information in making a decision about the suitability of the home. They benefit by having detailed assessments carried out on them and have opportunities to view the service before deciding to live at Argyle Road. EVIDENCE: A random sample of three residents’ files were assessed and from the evidence gathered, residents generally have a thorough assessment prior to coming to stay in the home. In all cases pre-assessment information was sought, although it was noted that the quality of such information is, at times variable. Nevertheless, residents and their relatives are given support and opportunities to determine whether the home is suitable for meeting the needs of the individual. It was also clear that they (residents) are involved in the admission’s process, which is positive. The home accepts emergency referrals – being a respite service. In such cases residents have limited opportunities to visit the service. However there was evidence that all assessments are carried out, as well as the acquisition of information from external sources. The assessment process ensures that residents once admitted, would be given the care and support to meet their needs. Argyle Road (Respite Care Project) DS0000025885.V361280.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): (6,7,9) People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. Residents benefit from having their needs (including their specialist needs), reflected and reviewed in their individual plan. There was evidence that they take decisions with support, and maintain their safety and independence within a risk management framework, although risk assessments needed to be more detailed. . EVIDENCE: From the care plans viewed, it was clear that residents have opportunities to be involved in planning their care, which ensures that they are not only aware, but accept responsibility for their direction. As part of this arrangement, they have the benefit of a key worker who works closely with them in setting up and reviewing their individual plan. The care plans viewed were updated and individualised, detailing the specific needs of residents – including their special needs. Staff interviewed had a sound understanding of the residents’ needs, which is good evidence to indicate how closely the staffing team worked with them. Staff play a major role in enabling residents to make decisions about their goals and objectives. In this respect they support individuals to pursue their Argyle Road (Respite Care Project) DS0000025885.V361280.R01.S.doc Version 5.2 Page 11 social and educational aspirations. Once agreed the actions are detailed in the care plans so that an audit trail is available, which is positive. Residents’ meetings are held regularly, despite the frequent turnover of residents. In these meetings key decisions are made, including the type/s of activities they would prefer, how they spend their time, the types of food they eat, whether they want visitors, as well as playing a part in staffing recruitment. There was evidence of pictorial books to support residents in making decisions around the home and in their lives. From the training records seen, staff had the benefit of training in - ‘The Mental Capacity Act’ 2005, which requires them to demonstrate why decisions cannot be made by residents in particular areas. The organisation (RCHL) also involves residents in business planning days – the last one being held (22/09/07) and other central information days e.g. on the 15/03/08 ‘ What things do you want RCHL to work on for you’. The outcomes of such involvement are reported upon in ‘RCHL Annual Report for people who use their services’. Residents are actively supported to use advocacy services and allocated funding is made available for such purposes. This is a strong area of the homes operations. There was a general improvement in the quality of risk assessments seen at the home. More importantly they were linked to care plans so that staff could use them to promote residents independence whilst minimising risks to their health and welfare. Staff spoken to understood the importance of assessing, reporting and evaluating risks. However, some of the risk assessments seen did not carry enough detail, regarding the risks identified. This needs to improve Argyle Road (Respite Care Project) DS0000025885.V361280.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): (12,13,15,16,17) People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. Residents are encouraged to participate in their community, in appropriate activities and are able to maintain and develop social and personal networks of their choosing. They are also given support to exercise their rights, which are respected and promoted by staff in the home. At Argyle Road staff provide meals that are reflective of service users’ choice and nutritional requirements. EVIDENCE: There was evidence that residents were supported to develop and maintain their living skills however restricted they might be. This is true despite having varied and complex levels of needs. The ethos of the service involves residents being supported to develop and as far as possible maintain their living skills. One example of this is where a resident who has been in the home for a longer period being supported to use the phone and this enabled him to keep in touch with his family. Another example could be drawn from where prior to a resident moving into a more independent scheme – work was done with the individual around cooking, money management and safety in the community. This is positive. Argyle Road (Respite Care Project) DS0000025885.V361280.R01.S.doc Version 5.2 Page 13 Given the complexity of needs and the short duration of most stays it is sometimes challenging to enable some residents to fully embrace their community. However, at Argyle Road opportunities to engage with the community is offered to all residents. In the month of April for example residents enjoyed a range of activities, which, included; bowling, a pub night out, a quiz – night and a cinema evening. In addition to this, they had internally; a movie night and a Caribbean night in which ethnic foods from the Caribbean are prepared. Residents are therefore exposed to a wide range of community activities, which they help plan and choose. More importantly they make their choices from a pictorial programme of activities developed with staff for their benefit. Residents are therefore able to use the community to pursue their development and leisure interests along with having opportunities to enjoy the resources and facilities internally. During the course of the inspection the relative of one of the residents came to the home to assist in promoting the best interest of a resident that was in some discomfort. Staff was observed negotiating this position as the relative wished to be involved in the process to ensure the resident’s welfare was promoted. Residents’ files bore evidence of the contact details of the next-of – kin or nearest relative. Staff have supported residents to visit their relatives for example in hospitals. Relatives are strongly encouraged to get involved in the scheme, particularly when a resident is admitted as an emergency. One relative commented: “the staff here are excellent they keep you informed every step of the way, particularly when it maters the most” This is positive practice. Residents are addressed by their preferred names and are able to choose what they wear and the times they wakeup and go to bed. Staff were observed checking with the resident in the home on the day, about her preferences around food and personal support. Advocacy information is made available to residents and the key worker system is used as a means of ensuring that the rights and needs of residents are respected and provided for. It was clear from the documentation seen and the feedback provided by residents, that their rights are maintained through the level of involvement that they have in deciding what is best for them. There was an improvement in this area as meals were recorded more consistently by staff if the home. A range of menus were available on the day of the site visit, and from the records seen, meals consumed were duly recorded. Feedback received from residents confirmed that they choose what they want to eat and that they are given advice on eating healthy. All residents spoken to were happy with the content and quality of the foods provided and this included a fresh supply of fruits and vegetables that were available on the day. Some residents are encouraged to prepare meals, which they enjoy as part their skill development. Feedback received from relatives was positive about meals provided at Argyle Road. It is accepted that the nutritional needs of residents are well provided for. Argyle Road (Respite Care Project) DS0000025885.V361280.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): (18,19,20) People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. Residents enjoy personal support in a manner that is generally suited to them. Arrangements are in place to provide for their physical and emotional health needs, although this could be improved. Good support is provided with medication in promoting the health and welfare of residents. EVIDENCE: Feedback received from residents and some relatives was positive with regard to how they (residents) received personal support from staff working in the home. This is usually coordinated through the key-worker system. Generally residents are able to independently manage their personal care and most times may require a bit of prompting to achieve this objective. It was also clear that the staff had a system for determining individuals’ preferences and dislikes, which made the relationship between the residents and staff – a positive one. Some of the examples provided of good personal support included; adapting ground floor facilities for an individual with mobility problems and arranging physiotherapy for another. Residents have their individual style of dress, which was consistent with their choice, culture and personality, and this was promoted in the home. Residents are generally given good support to ensure that their health needs are provided for, e.g. dentist and opticians. It must be noted that Argyle Road Argyle Road (Respite Care Project) DS0000025885.V361280.R01.S.doc Version 5.2 Page 15 is a respite service and much of the health care support is arranged by carers/relatives. From looking at the records and staffing interviews it was clear that staff were capable of making interventions to promote the health and welfare of most of the residents in their care. However on the day of the site visit there was evidence that some staff did not follow actions that would have better promoted the health and welfare of a service user who was clearly unwell. This observation was discussed in detail with the interim manager and a senior member of staff with a view of improving outcomes for the resident concerned and/or prospective residents. It be stated that the senior staff concerned did work beyond the time of her shift to avert further distress to the resident. At the time of the visit, one resident was able to manage their medication independently and with little staff support. Risk assessments are carried out as part of the process to minimise risk, whilst endeavouring to promote resident’s independence. A satisfactory medication procedure is in place for the benefit of staff and they have had medication training. The local pharmacist monitors the medication system, including medication practices within the home. Recommendations are made with a view to maintaining and improving the outcomes for residents that receive support with their medication. Medication records, storage, disposal and general administration has been in line with the national minimum standards, its associated regulations (CRH2001), and other legal requirements. Residents’ health and welfare is therefore promoted with the support provided with medication by the managements and staff at Argyle Road. Argyle Road (Respite Care Project) DS0000025885.V361280.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): (22,23) People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. A satisfactory complaints procedure is in place and widely available to all residents and staff. Safeguarding adults’ practices within the home generally protects residents from abuse, although this could be enhanced by ensuring that an updated safeguarding protocol is made available to all staff working in the home. EVIDENCE: A satisfactory complaints procedure is in place at the home and is made widely available in appropriate formats to all residents. From discussions held with staff and relatives, they felt able to raise issues of concern, should they feel the need to. The complaints record was analysed and in the main, complaints were logged and dealt with in line with the home’s complaints’ procedure. Staff interviewed demonstrated a clear understanding of the importance supporting residents to raise concerns should they be unhappy about any aspect of the service. There was evidence that staff were in receipt safeguarding training and that a policy was in place to direct them in dealing with safeguarding issues. However, the policy was been produced in 2004 and is in need of updating. A policy on dealing with aggression towards staff was not in place and so staff could feel quite challenged if and when placed in situations of that nature. This could result in staff inappropriately dealing with aggression from residents. It was noted that there were no safeguarding issues, since the last inspection, although the management of the home has raised safeguarding alerts over the same period. These alerts were raised as result of information provided by residents coming for respite care at Argyle Road. Residents felt safe disclosing their experiences from their previous environment with the management and Argyle Road (Respite Care Project) DS0000025885.V361280.R01.S.doc Version 5.2 Page 17 staff when they come n their private environment. There is good evidence that this information has been acted upon promptly and in the residents’ best interests. Argyle Road (Respite Care Project) DS0000025885.V361280.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): (24,30) People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. Residents live in a clean, and suitably designed home that matches their needs and lifestyles. They enjoy using their facilities, which are homely and personal, including their shared spaces. The home is clean and hygienic and fit for its purpose. EVIDENCE: Although the inspection was unannounced, the home was clean bright and airy on the day of the site visit. Decorative works were carried out to enhance the homely feel to the environment and residents were quite happy with it. Feedback from residents and their relatives indicated that they were pleased with the quality of the environmental facilities provided at Argyle Road. The registered persons were required to replace damaged net curtains in the home and this has been complied with. Some furniture was also purchased and a programme for renewals and maintenance is in place at the home. The laundry facilities were designed to promote the residents’ independence as far as possible. It was also designed to ensure that they could develop their skills in this area. An infection control policy is in place and residents and staff are encouraged to work within this e.g. hand-washing. The laundry equipment Argyle Road (Respite Care Project) DS0000025885.V361280.R01.S.doc Version 5.2 Page 19 is designed to cater for soiled linen and appropriate arrangements were in place for maintaining them. The layout of the home is such that foul linen is well away from food preparation and so the risk of the spread of infection is minimised. A new washing machine has been purchased. The services and facilities do comply with the Water Supply Regulations 1999. It must be noted that the feedback received residents, relatives and professionals was quite positive about the cleanliness and quality of the environment. Argyle Road (Respite Care Project) DS0000025885.V361280.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): (32,34,35,36) People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. Residents receive care and support from a staff team that is motivated to work with them. Their welfare and best interests are promoted by ensuring that generally staffing levels do reflect their needs. Recruitment practices are robust, which means that residents are protected from coming into contact with individuals not suited to work with them. Improvements in the support and developmental systems for staff, ensures that residents receive a higher quality of care and support. EVIDENCE: At the time of the inspection the service operated with a manager and seven care staff, three of whom were in a senior role. There was evidence that training had been provided for the benefit of staff in: Safeguarding Adults, Food Hygiene, The Mental Capacity Act, Working with Resistance and Low Motivation and Lone –Working. While this training is appropriate to the service that is provided at Argyle Road, there were low numbers of staff completing the basic NVQ Level 2 in Care. Staff observed, and interviewed, were well aware of their roles and functions and generally the links to the statement of purpose and their job descriptions. One of the support staff had completed the NVQ Level 3 in Care, while a senior member of staff was undertaking the course. Argyle Road (Respite Care Project) DS0000025885.V361280.R01.S.doc Version 5.2 Page 21 This means that the national minimum requirements that a minimum of fifty percent of the staff team achieving an NVQ Level 2 in Care is not satisfied. Residents, their relatives and external professionals were happy with the quality of care and support that is provided at Argyle Road. However a recommendation would be made in this report for the care staff to achieve the national minimum requirement with regards to the NVQ Level 2 in Care training. It was noted that a training plan was in place and that training for staff had been diarised for various months in 2008. On the day of the visit the staffing recruitment records were not available for inspection and the Commission requested the information and for it to be sent to its offices. The inspector did not have the benefit of this information at the time of writing this report and so a requirement would be made for the registered persons to supply this information to the Commission as originally requested. The inability to assess these records means that the inspector is unable to comment on the quality of staff that are recruited to the home and the robustness of the recruitment practices in ensuring that residents are safeguarded. Feedback from relatives, residents and external professionals indicated that generally residents’ needs are adequately provided for. As stated previously in this report (NMS 19) there was evidence that staff could do better in promoting the health and welfare of residents. Staff interviewed had a good knowledge of the service and more importantly - the special needs of residents. All staff have the benefit of induction training along with the General Social Council’s Code of Conduct, which is positive. Despite recent changes in the staff team, a core remains in place, which is positive for promoting consistency, which residents look forward to. From interviews held with staff – the changes in the management of the home did not adversely impact on their ability to carry out their functions. There was an improvement in the number of appraisals carried out with staff and supervisions were held regularly. This is enhanced by the convening of regular team meetings, which staff commented positively about. They felt supported by the new manager and this is positive. Residents commented positively about the staff in the home Argyle Road (Respite Care Project) DS0000025885.V361280.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): (37,39,41,42) People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. Management systems are in place to provide a good service at Argyle Road. Good quality assurance systems are implemented to enhance this. Health and safety practices within the home generally protect residents. except in the area of food storage. Improvements in the frequency of policies and procedures are required to enhance the overall quality of the service. EVIDENCE: As stated previously in this report, the registered manager and her deputy had moved on fro the service and an interim manager was in place. This individual has both managerial and expertise with the resident group. Feedback received from staff, relatives and residents was quite positive about the current manager. He demonstrated a vision for the service and was able to keep the staff team together to provide good quality care and support to the resident group. He has support from a senior manager in RCHL and it was recently communicated that plans were in place to appoint a permanent manager. Argyle Road (Respite Care Project) DS0000025885.V361280.R01.S.doc Version 5.2 Page 23 There was evidence that an internal audit was carried out by the organisation as well as a financial audit in March 2008. A development plan is in place for the service and the organisation provides a range of opportunities for residents to give their views, influence and shape the service. A mechanism (use of questionnaires) is in place to elicit the views of staff, relatives and external professionals. The Commission receives regular monthly monitoring reports as required under Regulation 26 of the Care Homes Regulations 2001. These reports are generally informative and give a picture of the homes operations o a monthly basis. The organisation is also keen to involve residents in staffing recruitment and its overall strategy. This is a strong area of the service operation. The health and safety file was assessed and all records on; appliance safety, fire safety and electrical safety were in order. There was evidence that staff have as part of their induction, appropriate training in health and safety. Safety signs were also appropriately displayed throughout the home and all areas of the home were safely accessible to the residents. Risk assessments were in place for all residents and the COSHH risk assessments were carried out as required to ensure their safety. Accident and incident records were well maintained. There was one area that needed improvement, which was food storage. A number of foods were found inappropriately stored. This needs to improve to ensure that residents are safe. In general residents’ interests are promoted with the policies and procedures that are in place. However, there were a number of policies and procedures that were outdated and in at least one case not in place e.g. ‘Aggression towards staff.’ Some of the outdated policies included: ‘Control of Substances Hazardous to Health’, ‘Bullying’, ‘Concerns and Complaints’, ‘Access to files by service users/staff, ‘Food Safety and Nutrition’, ‘Gifts to staff’, record keeping’ and ‘Managing service users money’. It must be stated that the areas identified do not form part of an exhaustive list and the registered persons must carrying out this review as a mater of urgency. Argyle Road (Respite Care Project) DS0000025885.V361280.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 x 2 3 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 x 34 2 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 4 x 2 x LIFESTYLES Standard No Score 11 X 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 3 x 3 x 4 x 2 2 x Argyle Road (Respite Care Project) DS0000025885.V361280.R01.S.doc Version 5.2 Page 25 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 YA9 Regulation 13(4)(c) Requirement Timescale for action 15/09/08 2. YA19 13 3. YA23 13 4. YA34 19 The registered persons must ensure that risk assessments detail all actions required to minimise risks to individual residents. This is to make it safer for residents. The registered persons must 15/09/08 ensure that staff follow up all actions relating to health promptly. This would reduce the risk of discomfort and distress to residents in enhancing their wellbeing. The registered manager is 15/09/08 required to: 1) review and update the safeguarding procedure in line with the Local Authority’s safeguarding and 2) make available to staff a policy on dealing with aggression towards staff. This to ensure that the risk/s to residents being abuse are kept to a minimum. The registered persons are 15/09/08 required to make available to the Commission information on the recruitment of staff in line with the Schedule 2 of the Care Home Regulations 2001. This is to ensure that residents remain DS0000025885.V361280.R01.S.doc Version 5.2 Argyle Road (Respite Care Project) Page 26 5. YA41 12,13 6. YA42 13 safe when coming into contact with staff employed in the home. The registered persons are required to review policies that are outdated and currently used in the home. This is to ensure that residents and staff have updated information to live and work safely in the home. The registered persons are required to ensure that food is stored appropriately at all times. This is to promote residents’ safety. 30/09/08 15/09/08 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 YA32 Good Practice Recommendations The registered persons should provide staff with the opportunity to complete the NVQ Level 2 in Care training. Argyle Road (Respite Care Project) DS0000025885.V361280.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection London Regional Contact Team Caledonia House 223 Pentonville Road London N1 9NG 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 Argyle Road (Respite Care Project) DS0000025885.V361280.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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