Please wait

Inspection on 29/08/08 for The Firs And Hewlitt

Also see our care home review for The Firs And Hewlitt for more information

This is the latest available inspection report for this service, carried out on 29th August 2008.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

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

Firs and Hewlitt successfully provide a diverse range of services to people with both a physical and a learning disability. The age range of people living in both services is substantial with both services now accommodating people who are becoming older and much frailer. Care plans have been further improved and now provide a pictorial insight into the needs of the individual. Risk assessments are thorough and detailed with individual risk assessments being reviewed since the last inspection was carried out. Staff training records were inspected and all mandatory training was up to date and includes infection control, food hygiene, epilepsy, moving and handling and Mental Capacity Act training. The manager and staff have worked hard to further develop and improve the internal decoration to both services, in particular people`s bedrooms reflect their interests and hobbies and are homely and comfortable. There are a number of care management systems in operation that focus on the wellbeing, autonomy and independence of people. Health and safety procedures were up to date and had been reviewed since the last inspection was carried out. Both services had up to date fire risk assessments in place.

What has improved since the last inspection?

These two services are registered with one manager although The Firs and Hewlitt are run separately, with all procedures and documentation held separately within the respective services. Also the staff teams are separate. Both services have been without a deputy manager for sometime and therefore the registered manager has been managing the two services without any another management support. There has been an improvement in recording ands monitoring of care plans, risk assessments and health and safety records. Both services now actively record all waking night care checks that are carried out which offers an effective audit of the care provided. The hand washing/drying facilities have now improved with infection control standards being met in both services.

What the care home could do better:

The manager and staff in both services must ensure that ongoing assessments of everyone using this service must be carried out on a regular basis as there are a large proportion of people who are reaching or are over the age of 65 years and who will need additional support and care associated with aging. The services need to be continually aware of this and ensure their placements can be maintained. The user of the service (or their representative) had not signed one of the care plans inspected. However all other care plans inspected were complete. The manager should ensure that anyone using bedrails has been consulted and evidence of the rationale for the use of them and agreement to their use should be held within the service and within the care plan.

CARE HOME ADULTS 18-65 The Firs And Hewlitt Woodside Road Abbots Langley Watford Hertfordshire WD5 0HT Lead Inspector Julia Bradshaw Unannounced Inspection 29th August 2008 10:00 The Firs And Hewlitt DS0000019569.V371012.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 The Firs And Hewlitt DS0000019569.V371012.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. The Firs And Hewlitt DS0000019569.V371012.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Firs And Hewlitt Address Woodside Road Abbots Langley Watford Hertfordshire WD5 0HT 01923 681157 01923 681157/8 hewlitt@lot-uk.org.uk www.lot-org.uk Life Opportunities Trust 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) Mrs Catherine Cadoo Care Home 15 Category(ies) of Learning disability (15), Learning disability over registration, with number 65 years of age (15), Physical disability (15), of places Physical disability over 65 years of age (15) The Firs And Hewlitt DS0000019569.V371012.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 30th August 2007 Brief Description of the Service: The Firs and Hewlitt is a home providing personal care and accommodation for fifteen adults with learning disabilities, some of whom also have a physical disability. The home is owned and managed by Life Opportunities Trust (LOT), which is a voluntary organisation. The Firs and Hewlitt is located on the outskirts of Abbots Langley, a short walk from a shopping precinct that includes a surgery, pharmacist, convenience store and a restaurant. A little further away is the village of Abbots Langley, which has shops, pubs and a library. There is a local bus service to the towns of Watford, St Albans and Hemel Hempstead. The service was opened in 1993 and consists of two purpose-built detached buildings that are accessed via a private drive. The Firs is a bungalow comprising a lounge, dinning room, kitchen, laundry room, seven bedrooms and two bathrooms, one with a shower and hoist and one small toilet. Hewlitt is a chalet style house, with a similar layout to the Firs, except that it has six bedrooms on the ground floor and two on the first floor, accessed by a stair lift. All the bedrooms are single; none of the bedrooms have en-suite facilities. The service has a large, well maintained garden area. There us an up to date Service User’s Guide and Statement Of Purpose, which sets out information about the service and the services offered for prospective users of the service. Copies of these and the inspection reports by the Commission for Social Care Inspection (CSCI) are available within the service. Current charges are £910 to £948 per week (as at 29/08/08). Additional charges are made for hairdressing, personal toiletries and newspapers. The Firs And Hewlitt DS0000019569.V371012.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 information in this report is based on an unannounced visit to the home by one regulation inspector carrying out the work of the Commission. The inspection covered a variety of aspects of this service including talking to people who use the service and staff members, a tour of the building, an examination of the staff training records, four care plans were case tracked, health and safety records were also examined and the management systems within the service were also inspected. The manager of both these services was on a training day and therefore a senior support worker conducted the majority of this inspection. The Firs and Hewlitt is registered as one service although they are clearly run independently of each other. With peoples complex and changing needs as they get older thought should be given to appropriateness of this registration. The new manager has been in post for a period of six months and has worked hard to improve and implement recording and quality monitoring systems. The staff teams in both services have been working without a full compliment of staff recently and covering vacancies with bank staff on short-term contracts to ensure some continuity is provided to the residents. However, the senior support worker stated that this situation has improved with the appointment of a new deputy manager in Hewlitt and both services now have a senior post and there has been an increase in waking night care from two to three waking night care per night. An advert is currently out for remaining vacant deputy post in Firs. What the service does well: Firs and Hewlitt successfully provide a diverse range of services to people with both a physical and a learning disability. The age range of people living in both services is substantial with both services now accommodating people who are becoming older and much frailer. Care plans have been further improved and now provide a pictorial insight into the needs of the individual. Risk assessments are thorough and detailed with individual risk assessments being reviewed since the last inspection was carried out. Staff training records were inspected and all mandatory training was up to date and includes infection control, food hygiene, epilepsy, moving and handling and Mental Capacity Act training. The Firs And Hewlitt DS0000019569.V371012.R01.S.doc Version 5.2 Page 6 The manager and staff have worked hard to further develop and improve the internal decoration to both services, in particular people’s bedrooms reflect their interests and hobbies and are homely and comfortable. There are a number of care management systems in operation that focus on the wellbeing, autonomy and independence of people. Health and safety procedures were up to date and had been reviewed since the last inspection was carried out. Both services had up to date fire risk assessments in place. What has improved since the last inspection? What they could do better: The manager and staff in both services must ensure that ongoing assessments of everyone using this service must be carried out on a regular basis as there are a large proportion of people who are reaching or are over the age of 65 years and who will need additional support and care associated with aging. The services need to be continually aware of this and ensure their placements can be maintained. The user of the service (or their representative) had not signed one of the care plans inspected. However all other care plans inspected were complete. The manager should ensure that anyone using bedrails has been consulted and evidence of the rationale for the use of them and agreement to their use should be held within the service and within the care plan. The Firs And Hewlitt DS0000019569.V371012.R01.S.doc Version 5.2 Page 7 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. The Firs And Hewlitt DS0000019569.V371012.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 The Firs And Hewlitt DS0000019569.V371012.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): 1 –5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Information about the service is kept up to date and provided for all prospective users of this service and everyone wishing to enter the service has a full assessment of need completed. This ensures that all parties can be sure the service can meet all individual needs. The terms and conditions of the service are agreed in writing so that people are clear about the roles and responsibilities of all those within the service. EVIDENCE: A detailed pictorial Statement of Purpose and Service User Guide is in place. These are kept up to date and are available to prospective users of this service. Both these documents have been updated since the last inspection took place. A total of four care plans were reviewed and evidence was seen regarding the initial assessments that are carried out to access if the service can meet the needs of the person. Information is held regarding the person’s history and current needs. The Firs And Hewlitt DS0000019569.V371012.R01.S.doc Version 5.2 Page 10 An assessment of each person’s needs and aspiration are made before the person moves into the service. Competent and qualified staff complete these assessments. The service also receives and seeks external specialist support to meet the individual’s needs. Whole life reviews and CPA’s occur to support the people in achieving and reviewing individual needs, goals and aspirations. The assessment process includes the gathering of information from other professionals. Firs and Hewlitt has its own internal assessment forms, which have been further developed since the last inspection was carried out. A contract is then drawn between the service provider and the person using the service. The contract includes the Terms and Conditions within the service and the rights of the people who live at Firs and Hewlitt. The Firs And Hewlitt DS0000019569.V371012.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. People who use the service can be confident that the care plans reflect a detailed and comprehensive record of people’s needs, which ensures that people using the service are assessed, reviewed and safe from risk. EVIDENCE: Four care plans were inspected in detail and were found to provide a detailed insight into each individual’s needs. Individual notes and guidelines for people were observed within the service. The manager and staff have worked hard to produce theses care plans in a pictorial format that can be easily understood by each person living within the service. Everyone living at both Firs and Hewlitt is supported within the whole life review or CPA framework and reviews occur to ensure changing needs are continuously assessed and reviewed. Ranges of risk assessments are completed within the service and actions points recorded. These risk The Firs And Hewlitt DS0000019569.V371012.R01.S.doc Version 5.2 Page 12 assessments are detailed and contain all the required information. Activities and outings enjoyed by people living at Firs and Hewlitt determine that people are supported to take risks as part of an independent life style. Risk assessments have been reviewed since the last inspection was carried out. Staff work with people to assist them to lead safe and enjoyable lives and regarding decision making and offering support where needed. There was evidence to confirm that people had been involved in their care planning with signatures from either the person using the service or their representative. However one care plan requires either the person using the service or their representative to sign to confirm they have read and agreed the content of their plan. People spoken to on the day of the inspection were all positive about the way that care is received in terms of preserving rights and dignity. People spoken to state, “The staff here are all really nice and they take me out and we go on holiday”. Another person said that “the staff help me to have a bath and to clean my room”. The Community Learning Disabilities team based in Watford provides health care support where required. The Firs And Hewlitt DS0000019569.V371012.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): 12,13,15,16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service can feel assured that they will be offered and receive appropriate opportunities for social, leisure and community involvement, which meets their needs and expectations. EVIDENCE: Individual activity programmes are in place and form part of the care plan/Person Centred Plan. Activities are selected to meet people’s interests and where appropriate to enable them to achieve realistic personal development goals. The support plans inspected demonstrated how people are supported to enjoy appropriate community resources. Some people attend a local daycentre and some people have retired from full time daycare and prefer a quieter life within the service where staff on duty provided in –house activities for people wishing to remain at home. Both services encourage and support people to maintain links with families and friends. The Firs And Hewlitt DS0000019569.V371012.R01.S.doc Version 5.2 Page 14 The people living within both services have enjoyed a variety of trips out to the cinema, to local pubs, coffee shops and the library. A variety of holidays have taken place since the last inspection, which include, taking one person to Blackpool, two people went to Chichester and a trip to Southend is planned for next Friday. Routines within both services are designed to promote people’s independence skills. However some of the people living within both services have limited independence skills due to their advancing years and for some people, a life that has involved extensive years of institutional care. The inspector therefore has assessed the quality of life for these people against the need to further develop these daily living/independent skills. The outcome for these people is therefore considered good. People living within both services are unrestricted in their movement around the home. Menus are offered on a flexible basis, with people making informed choices over their meals. Meals observed were unrushed and relaxed. Adequate food stocks were noted in the kitchen cupboards and freezer. Particular food preferences and dietary needs are noted in the care plans. However, both services should endeavour to produce menus in a format that can easily be understood by everyone living within both houses. The Firs And Hewlitt DS0000019569.V371012.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18 -20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Those who use the service have their health and personal care needs carried out effectively and respectfully, ensuring that their wishes and choices are promoted. EVIDENCE: All care provided is individual and tailored to each person needs with each person choices and preferences being promoted. Assessments are completed ensuring that the approach adopted is person centred and holistic to each person. People are supported with all aspects of their physical and emotional health and receive adequate and appropriate input from specialists such as community nurses, consultants, GP, dentists, opticians and dieticians. Information and advice is provided to everyone living within both services regarding general health issues. A robust policy and procedure is in place to support the safe administration, storage and receipt of medicines. Medication training was evidenced from the training records for all staff who administer medication within this service. The Firs And Hewlitt DS0000019569.V371012.R01.S.doc Version 5.2 Page 16 Staff spoken to on the day of this inspection confirmed that they had been both inducted and trained in the administration and safe keeping of medication. The services use the dossette system to dispense medication and the MAR sheets were reconciled with no errors were found. Neither of the services currently holds controlled medication but both services have a policy in place if this is required. The recent AQQA states that a weekly medication audit has been introduced to ensure any errors in medication are quickly identified and rectified. Everyone using the service has a health action plan and essential life style plans, which were seen as part of this inspection. There are some people living within both Firs and Hewlitt who have complex physical care needs and as part of this inspection two care plans were inspected in relation to moving and handling assessments and risk assessments. Also documentation in relation to hoists and other specialist equipment was inspected and found to up to date. Bed rails are used in some circumstances and the manager must ensure that the rationale for their use and consent from either the user of the service or their representative been obtained and remains on their file for the purposes of inspection and good practice. The Firs And Hewlitt DS0000019569.V371012.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. 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. People living in this service can be assured that they will be protected from abuse and that they will be listened to if they raise any concerns or make a complaint about any aspect of their care. EVIDENCE: The service has a detailed complaints procedure in place. A record is maintained in the home of any complaints made detailing actions and outcomes as necessary. People using the service have been informed about the complaints procedure. The recent AQQA stated that there has been one complaint received since the last inspection was carried out and that this has been resolved to a satisfactory conclusion. Records to confirm this were seen on the day of the inspection. A detailed procedure is in place to ensure that people using the service are protected from abuse and harm. Staff receive suitable and adequate safeguarding training. Staff employed within the home are all subject to an enhanced Criminal Records Bureau disclosure prior to employment. The Firs And Hewlitt DS0000019569.V371012.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 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The environment is maintained to a good standard where people using the service can feel safe and protected. EVIDENCE: On the day of this inspection one of the houses (Firs) had been without electricity for a prolonged period of time (overnight), due to some maintenance work being carried out on the main road leading to the services. However EDF electricity had been able to link Firs up to Hewlitt’s power supply temporarily and the fault was rectified and the service back on full power supply before the inspector left . A variety of redecoration has been carried out since the last inspection in August 2007.This includes, three bedrooms have been redecorated and the laundry room has also been repainted. Firs have received a new dishwasher The Firs And Hewlitt DS0000019569.V371012.R01.S.doc Version 5.2 Page 19 and new hob. Both kitchens could benefit from being re-furbished, as they are now looking shabby and damaged in parts due to wear and tear. All specialist equipment has been serviced since the last inspection. People as they grow older need more light and the services could also benefit from improving the external lighting to both houses to ensure people are not put at unnecessary risk. With the exception of the external lighting the sufficient lighting, heating and ventilation is provided internally. Both houses are wheelchair accessible. Both services have improved their infection control practices and now provide adequate hand washing facilities in all areas of these services, which ensures that people are better protected. The home was clean and odour free on the day of the inspection. The cleaning is carried out by the care staff and with people assisting where possible. The manager monitors this to ensure that standards of cleanliness are maintained. The kitchen and laundry rooms are domestic in style and appear to manage their current workload effectively. Each person has a single bedroom, which has been furnished to meet people’s individual needs and reflects their preferences. The communal areas of the services are decorated and furnished to an acceptable le standard and there is a selection of home entertainment equipment for service user to access. The water temperatures on the day of the inspection were recorded within safe limits, which ensure people are protected from accidental scalding. Firs and Hewlitt have pleasant grounds for people to enjoy in the warmer weather that are accessible to all. The Firs And Hewlitt DS0000019569.V371012.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 and 35. 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 can be confident that an experienced and welltrained staff team have been recruited to ensure the residents continued safety and welfare is protected. EVIDENCE: All the staff demonstrated their commitment to their work in caring for the people who use the service. Three members of staff spoken to during this inspection stated that “they found the manager approachable and the training opportunities were good” There was adequate information provided by the manager and also stated in the recent AQQA to confirm that staff are receiving adequate training and supervision to carry out their roles effectively. Staffing levels are adequate in both services to ensure people receive the appropriate care and support. The manager is supernumery to these staffing The Firs And Hewlitt DS0000019569.V371012.R01.S.doc Version 5.2 Page 21 levels. There is three waking night care per night, divided between the two houses. The recruitment records were unable to be examined on this occasion as the manager was on a training course. However the AQQA states that “enhanced CRB checks are carried out and copies of staff application forms, health clearances, contracts, photo’s, references, birth certificates and car insurance details” are all held within the service to ensure and confirm that all staff recruitment procedures have been carried out in line with the companies recruitment policy. Previous inspections have not found this an area of concern. The new manager has been in post for a period of six months and there have been several staff changes within both services since the last inspection took place. However the recent recruitments within both services should help maintain the stability and consistency for the people living with both houses. There is now a senior support worker in each house and the manager is hopeful that the vacant deputy post in Firs will soon be filled. The manager stated that she spends two days in each service in order to ensure she is kept updated and informed on how the two services are functioning. The Firs And Hewlitt DS0000019569.V371012.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, and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at Firs and Hewlitt can feel confident that they are living within a service that is well managed and where systems in place protect them. EVIDENCE: Generally people living within the service are provided with information that can be understood in relation to the complaints procedure, although the service could further improve this information by creating all documentation in a more user friendly format that can be easily understood by the people using this service. The manager ensures that supervisions and staff training are held regularly and three staff spoken to on the day of this inspection confirmed that they feel supported and respected by the new manager. The Firs And Hewlitt DS0000019569.V371012.R01.S.doc Version 5.2 Page 23 The AQQA completed in June 2008 stated that all recruitment procedures are adhered and strictly complied with. However, recruitment records were not examined on this occasion, as staff on duty could not access this information, as the manager was not available. All records inspected were secure and were up to date and held in accordance with the Data Protection act 1998 ensuring that people’s rights and best interests are safe guarded by the homes polices and procedures. The management approach of the homes endeavours to create an open and positive atmosphere, staff and users of the service spoken to commented that they feel supported. “ I like all the staff, they are very kind to me” Individual and generic risk assessments were in place. The general standard of fire checks/recording is good and fire records on the day of the inspection were up to date and recorded accurate. The standard of both infection control and health and safety was found to be adequate in relation to the hand washing facilities, disposal of clinical waste and fire records/documentation. There were no mal odours on the day of the inspection in either house. The services should endeavour to produce all documentation that is relevant to people using the service, in a more user-friendly format that can be easily understood by everyone using these services. The Firs And Hewlitt DS0000019569.V371012.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 3 2 3 3 3 4 3 5 3 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 3 35 3 36 x 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 x 15 3 16 3 17 x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 3 x x 3 x The Firs And Hewlitt DS0000019569.V371012.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. 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. Refer to Standard YA2 Good Practice Recommendations The current arrangement of having only one registered manager for both services should be reviewed in light of the changing and more complex needs of the people using these services. These two services clearly operate independently of each other and possibly these two houses should be registered separately so to benefit the people that live there. This issue will be passed onto the regional registration team for further guidance and investigation. The service should ensure that people using the service have been consulted with regard to the use of bedrails. 2. YA18 The Firs And Hewlitt DS0000019569.V371012.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 The Firs And Hewlitt DS0000019569.V371012.R01.S.doc Version 5.2 Page 27 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!