Inspection on 05/01/07 for 1 & 2 Markyes Close

This inspection was carried out on 5th January 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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.

Other inspections for this house

1 & 2 Markyes Close 03/11/05

1 & 2 Markyes Close 06/05/05

1 & 2 Markyes Close 17/12/04

1 & 2 Markyes Close 02/09/04

1 & 2 Markyes Close 09/02/04

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Markyes Close 1 & 2 Edde Cross Street Ross-on-wye Herefordshire HR9 7BZ Lead Inspector Christina Lavelle Unannounced Inspection 5 &10 January 2007 12:15p th th Markyes Close 1 & 2 DS0000024681.V325539.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 Markyes Close 1 & 2 DS0000024681.V325539.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. Markyes Close 1 & 2 DS0000024681.V325539.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Markyes Close 1 & 2 Address Edde Cross Street Ross-on-wye Herefordshire HR9 7BZ 01989 769034 01989 769034 markyes@aspirechoices.com 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) Aspire Living Mrs Irena Victoria Bace Care Home 8 Category(ies) of Learning disability (8), Learning disability over registration, with number 65 years of age (8) of places Markyes Close 1 & 2 DS0000024681.V325539.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Service users may have physical disabilities in addition to their learning disability. The registered manager must achieve an NVQ 4/Registered Managers Award qualification by the 31st of August 2007. 3rd November 2005 Date of last inspection Brief Description of the Service: Markyes Close was first registered as a care home in 1992. The registered provider is Aspire Living and Choices Limited, which is a voluntary organisation and a registered charity. Aspire operate just in Herefordshire, running nine other care homes and a supported living scheme. Their head office is based at the Fred Bulmer Centre, Wall Street, Hereford, HR4 9HP. The manager (Mrs Vicki Bace) was registered in respect of the home in August 2006. The home provides accommodation with personal care for eight adults, men and women. Service users must be at least eighteen and can be over sixtyfive years of age. They must require care due to learning disabilities and may also have physical disabilities and/or a sensory impairment. Most service users have profound disabilities and may also use behaviours that can challenge a care service. Two of the main stated aims of the home are to respect service users’ rights as individuals and to assist them to establish active, fulfilled lives. Markyes Close is located in a convenient location in Ross–on-Wye, which is a small market town. The home is within an easy walking distance of the town centre and its shops, services and facilities. Suitable transport is also provided to enable service users to go out further afield. The property is owned by the Primary Care Trust and is leased to Aspire. The home comprises of two selfcontained purpose-built bungalows, next to each other. Both bungalows can accommodate four people and service users have single bedrooms with a wash hand basin but not en-suite facilities. Each bungalow has a lounge, separate dining room, assisted shower and bathing facilities, a kitchen and utility room for everyone to use. There are small secure garden areas behind the property. Information about the home is provided in a statement of purpose and service users’ guide, which are available from the home and Aspire’s head office. The guide is also produced in a format more suitable for people who have learning disabilities. The current fee for the service is £1331.57 per week. Additional charges are made for newspapers, transport, personal toiletries, private dentist & chiropody, holidays, dry cleaning and the fee for some specific activities. Markyes Close 1 & 2 DS0000024681.V325539.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is a key inspection of Markyes Close. This means the inspector checked all the Standards that can have most effect on the service users. The first visit was made without the inspector telling anyone she was going to come and took four hours on a Friday afternoon. The second visit was arranged at the first visit and took under two hours the following Wednesday in the morning. It is difficult to talk to service users about what they think of living at Markyes Close because of their communication difficulties. Time was spent with them in their sitting rooms to see what they were doing and how well they seem to get on with staff and each other. Two care staff were spoken with on their own. They were asked about their training and experience, service users and their care and how staff work together and are supported. The manager was on holiday and so the way the home is run and other management issues were also discussed with the home’s senior. Everyone was open and very helpful. Various records kept about service users, staff and that show how the home is kept safe were checked. Most parts of the bungalows were seen. Information was used from a questionnaire the manager completed before the inspection giving useful details about the current service. Six service users’ relatives (two on behalf of service users) and two advocates had sent in survey forms with their views of the home. Some of their comments are included in this report. All communication received by the Commission about the home since the last inspection is also considered. This including notifications of events that had affected service users. Also reports made by Aspire following their monthly visits to check that the home is being run properly. There have not been any complaints made or concerns raised about the service. What the service does well: There is good information to give possible new service users and the manager always meets them to check if the home could be suitable. They can also visit and try out the home to see if they would like to live there before moving in. It feels nice and friendly in the home. Service users seem happy and staff are caring and respectful to them. Service users’ families say they are always made welcome in the home and are kept well informed about their relatives and their care. Their comments are all positive including the following: “There is always a friendly and welcoming atmosphere in the home” and “I have always found staff at Markyes Close to be very caring and helpful in X’s care”. Service users all have a written plan of their care needs and of any risks. Plans help staff to know how to meet their needs and keep them safe. Service users are given more individual support from some staff, called their keyworkers. Markyes Close 1 & 2 DS0000024681.V325539.R01.S.doc Version 5.2 Page 6 Service users are supported by staff to take part in many different activities. They can go out if they want to as well as do things they enjoy when at home. Staff also ensure that service users have a variety of healthy meals they like. Service users receive all the help they each need with their personal care. Staff also make sure they stay healthy and have regular health care check ups. Their medicines are managed safely by staff in the home. Markyes Close is in a good place close to the shops etc. in Ross-on-Wye town. The home has given service users the opportunity to live in ordinary housing in the community. The home is specially adapted and has aids and equipment to help people who have disabilities. The bungalows are safe, well-kept and clean and are very homely and comfortable. The home has a good, stable staff team who receive training needed to know, understand and meet service users’ needs better and how to keep them safe. The manager is experienced and the home and is well run. The staff team have good management support and work together to ensure service users receive good care. An advocate said “The home is run with utmost professionalism”. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Markyes Close 1 & 2 DS0000024681.V325539.R01.S.doc Version 5.2 Page 7 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 Markyes Close 1 & 2 DS0000024681.V325539.R01.S.doc Version 5.2 Page 8 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&2 Quality in this outcome area is good. This judgement has been made using available evidence including these visits to this service. There is suitable written information about the home to help prospective service users and/or their representatives decide if they would like to live there Thorough assessment and admission procedures are in place to make sure that the home could suitably meet the needs and wishes of new service users. EVIDENCE: Aspire provides appropriate documents for the home, including a statement of purpose, a service users’ guide and a terms & conditions of residence. The guide is also available in a suitable format, with simple language and pictures, so that prospective service users are more likely to be able to understand it. There are written Referral/Admissions procedures, which Aspire agreed as part of their contract with Herefordshire Council. This document states that the Learning Disabilities Team will initiate the referral process to fill any vacancies and supply a community care assessment for the prospective service users. There had been one new service user admitted to the home during last year. This person’s relative confirmed they were fully consulted before they moved in and had been given relevant information about the home. The manager had Markyes Close 1 & 2 DS0000024681.V325539.R01.S.doc Version 5.2 Page 9 visited this prospective service user at their previous home and had obtained information about them and their needs from their family and social worker. Following the assessment visits, introductory visits to the home are normally arranged. However this service user’s admission was made in an emergency and as them visiting the home was not feasible, their relative did so for them. The senior staff member confirmed that introductory visits to the home would usually be for tea, followed by overnight and weekend stays. If these visits are successful a trial period of up to three months is arranged. At the end of this trial stay a review meeting is held involving the service user (whenever possible) home staff, the service user’s family and social worker. A decision is then made about the suitability and so the continuation of the placement. Markyes Close 1 & 2 DS0000024681.V325539.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 Quality in this outcome area is good. This judgement has been made using available evidence including these visits to this service. Service users receive good support from staff who make sure they each have a care plan so that their current needs and wishes are known and so met better. Service users make choices in their daily lives and routines to the extent they are able. Staff also consider any possible risks to each service user so they can help to keep them safe, whilst also encouraging their independence. EVIDENCE: A sample of service users’ care records was looked at. They include a personal profile, with details of each person’s background, health and condition. Some service users also have life books with photographs and information about their family and social history. Staff make detailed daily reports showing the activities each service user has taken part in, any personal care received, food & drink taken and their mood and behaviour. This all provides a helpful picture of how each person is currently, and of events and changes in their lives. Markyes Close 1 & 2 DS0000024681.V325539.R01.S.doc Version 5.2 Page 11 Each person has a care plan reflecting relevant areas of their personal, health and emotional needs including their daily living skills and communication. Plans have been drawn up in an appropriately person centred way so that service users’ individual preferences and goals are taken into account. It was noted that plans have been reviewed regularly so they reflect service users’ current and changing needs. Service users’ families and advocates are also involved in reviews and service users participate to the extent they are able to. Keyworkers are allocated to particular service users from the staff team. They have a specific responsibility to give more individual attention and time to these service users. They try to find out their likes & dislikes by knowing them better and through observation of their reactions etc. They help to arrange their activities, health care checks and keep in touch with their families and advocates. Their role also includes involvement in care planning and reviews. Relevant risk assessments have been carried out for the safety of service users and others. When necessary, advice had been sought from other professionals and management plans put in place in respect of behavioural issues. Staff are expected to read and sign risk assessments, including when they are updated. It is good that consideration is given to the diverse needs of service users. For example in respect of their physical disabilities and the aids & equipment they need to mobilise, receive care and to provide stimulation e.g. hoists, pressure relief cushions, special riser beds and sensory lights. For one person where support has needed to be from same sex carers, there is a policy, which was being fully reviewed. Some had input from a Speech Therapist to enable their communication and Aspire now employs a communication facilitator who will work with service users to set up an individual programme for them and staff. Markyes Close 1 & 2 DS0000024681.V325539.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 Quality in this outcome area is good. This judgement has been made using available evidence including these visits to this service. Service users are supported to lead as full and active a lifestyle as they want to. They take part in activities they enjoy both at home and in the community. Staff respect service users’ individuality and support them to maintain links with family and relevant others. They also ensure that service users receive a variety of wholesome meals they like and meet their special requirements. EVIDENCE: Service users’ plans include an activities programme and daily reports show what they have taken part in. Activities include some day services for varying weekdays, but are mostly geared up to meet individual needs and capabilities. The home has the benefit from deploying two activities co-ordinators whose role is solely to facilitate activities, which includes participation within the wider community. They regularly support service users to visit local shops, pubs and cafes and some people go to social clubs for people with learning disabilities. Markyes Close 1 & 2 DS0000024681.V325539.R01.S.doc Version 5.2 Page 13 Keyworkers also have some time for individual activities with their allocated service users. Whilst at home activities include massage, foot spa, sewing and puzzles. In the community they can go horse riding, to a snoezelen sensory facility and for walks. The home has two adapted vehicles to provide transport. There was a very relaxed and welcoming atmosphere in the home. In one bungalow music was playing quietly and staff were sitting with service users interacting positively with them. In both bungalows staff were seen to give guidance and support in a caring way. Service users clearly respond well to staff and those able to were happy to talk to the inspector. It is clear staff know service users and their personalities and behaviours and understand and deal with them appropriately and respectfully. Staff are also aware of service users’ preferred daily routines and work around them as much as possible Service users’ families and advocates were very positive about the home, as their comments reflect. Staff support service users to keep in touch with them through telephone calls, sending greetings cards and providing transport for visits. They can also have meals with their relatives at the home if they wish. Regarding food provision staff draw up a 4 weekly menu for the main meals. Each weeks meals include fish, roasts, casseroles, pasta and vegetarian dishes, which are varied and balanced. Meals can also be flexible and service users choose to the extent they can. Staff know their preferences and promote healthy eating by encouraging them to have such as fresh fruit, fibre etc. Food stocks included wholemeal bread, healthy cereals, fresh fruit and vegetables. Individual records are kept of meals, and when necessary drinks, each service user has taken. There is guidance in plans as to the oversight and assistance some service users need eating their meals. Also in respect of special dietary considerations for their good health, and staff are clear about what they should have. Mealtimes were seen to be a social and relaxed occasion. A Dietician and Speech Therapist had been appropriately consulted when needed and provided advice for staff and eating plans for service users. Plans show when service users are able to make their own drinks, although most are unable to help to any extent with meal preparation and cooking. Markyes Close 1 & 2 DS0000024681.V325539.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 Quality in this outcome area is good. This judgement has been made using available evidence including these visits to this service. Service users receive necessary support from staff to meet their personal and health care needs. It would help to confirm their health is being monitored; preventative steps taken and their good health promoted if each service user has a Health Action Plan. Staff are managing service users’ medicines safely. EVIDENCE: Service users’ care records detail the support each needs with their personal care and to maintain good hygiene. Records are kept of any support received. Service users were observed to be well presented and appropriately dressed. Care records also provide details of service users’ current health, any related issues and/or conditions with aims and who and how should deal with them. Checklists of physical checks are also kept when needed, such as weight, seizures and bowel movements. However staff should ensure that action taken and outcomes are always recorded to show that problems have been followed up and dealt with. One matter was discussed with the senior and although she was fully aware of these issues and described how they had been dealt with she agreed that staff should have been seen to be more proactive. Markyes Close 1 & 2 DS0000024681.V325539.R01.S.doc Version 5.2 Page 15 Records are also kept of routine health care appointments, such as dentist and optician and of any GP and specialist input. It is now considered good practice however for people with learning disabilities to have an individual Health Action Plan. These plans can help to ensure and confirm that their health is being monitored, that any problems are identified and their good health is promoted. This includes showing that all their special health care needs are understood and recognised and that they are being supported to stay healthy, through preventative as well as routine and specialist health care input. Any special needs relating to such as moving & handling are specified and all staff receive training and instruction in respect of using equipment, such as hoists. Protocols are also in place for specific medications needed, and such as choking and the need to use bedside rails for some service users’ safety. Regarding the management of service users’ medicines in the home all staff designated to administer have undertaken safe handling of medicines training, as expected, with a list kept of them It was confirmed there are safe storage arrangements for medicines and records of medicines kept and administered are being maintained appropriately. Markyes Close 1 & 2 DS0000024681.V325539.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 Quality in this outcome area is good. This judgement has been made using available evidence including these visits to this service. There is an effective system in place to support service users (and/or their representatives when they are not able) to express their views and concerns. There are policies and procedures and staff receive instruction to help them to protect service users from abuse, neglect and self-harm. EVIDENCE: The home provides a complaints procedure that is also in a suitable format. Whilst most service users would not be able to directly express their views and concerns it is good that their relatives and advocates say they know about the procedures and who to approach. Although they also say they have never needed to make a complaint about the service. There have not been any complaints raised with the Commission or the home. Although the home has made one referral under the multi-agency procedures for the Protection of Vulnerable Adults (POVA) this did not involve the care provided at Markyes Close and demonstrates the manager’s awareness of their responsibility to safeguard vulnerable adults. Aspire provides various policies & procures relating to service users’ protection, including abuse and whistle blowing. The home has a copy of Herefordshire multi-agency POVA procedures and the staff team have received training from the local Adult Protection co-ordinator. Relevant instruction is also included in the home’s induction of new staff. Markyes Close 1 & 2 DS0000024681.V325539.R01.S.doc Version 5.2 Page 17 It is confirmed that service users’ finances are managed appropriately. Whilst they are unable to manage their own monies they each have a savings account and any cash received from their personal allowance or relatives is carefully recorded by staff. Some cash is kept safely in the home and whenever staff use this money on service users’ behalf this is signed for and receipts are kept for any purchases. These records were checked and are kept appropriately and are also audited by the manager and deputy regularly. Markyes Close 1 & 2 DS0000024681.V325539.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 Quality in this outcome area is good. This judgement has been made using available evidence including these visits to this service. Markyes Close is conveniently situated and offers service users a suitable, safe, very homely and comfortable home. The arrangements in place to improve the accommodation, and to maintain and keep it clean are working effectively EVIDENCE: Markyes Close is in a good location, within walking distance of the shops and other facilities of Ross-on-Wye town centre. The bungalows were purpose built for people with profound learning and/or physical disabilities and who were living in hospital. They therefore provide a safe, secure environment for service users who may use challenging behaviours. There are also wide doorways & corridors, ramps, aids, assisted baths etc. for those with restricted mobility. The premises are in a very good state of repair, furnishings and décor. Since the last inspection a lot of redecoration has been done and there are new carpets and kitchens and the offices upgraded which all look very nice. Service users bedrooms are well personalised and reflect their interests and special needs in respect of such as special riser beds, sensory light & music systems. Markyes Close 1 & 2 DS0000024681.V325539.R01.S.doc Version 5.2 Page 19 Most bedrooms in the home have less space than the Standards specify for wheelchair users, which is at least 12 sq. metres. The registered persons are aware however that this would have to be taken into account when they are assessing the needs of prospective service users. If a wheelchair user is referred they should seek advice from an Occupational Therapist to confirm in writing that there is sufficient space for turning, transfers and access etc. Both bungalows were found to be clean, tidy, warm and are cosy and homely. Whilst service users are not able to take a very active role in household tasks staff clearly make sure that a good standard of hygiene and infection control is maintained. There are relevant policies and procedures and the home provides disposable gloves and aprons and paper towels. Suitable arrangements are also made for the disposal of clinical waste. Markyes Close 1 & 2 DS0000024681.V325539.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 Quality in this outcome area is good. This judgement has been made using available evidence including these visits to this service. Service users are well supported by a sufficient, suitably experienced and trained staff team, who are committed to providing a good service and know, understand and are meeting service users’ needs properly. The home’s recruitment procedures are thorough overall and so help to ensure that only suitable people are working with service users, for their protection. EVIDENCE: Rotas show that there are always two support staff working in each bungalow from 7.30am–9.30pm, with two staff on waking night duty. On four weekdays separate activities facilitators are also deployed, some days both work. Most weekdays the manager or senior work normal weekday hours, in addition to direct care hours, for the administrative and management tasks. This reflects suitable staffing levels to meet service users’ needs and run the home. Although there has been some staff absence recently generally the home team are able to cover the gaps and agency staff only used when really needed. In this event they use one particular agency whose staff are suitably trained and now know the home and so the service users fairly well. Markyes Close 1 & 2 DS0000024681.V325539.R01.S.doc Version 5.2 Page 21 Aspire’s recruitment procedures were discussed with the senior and appear to be thorough. One fairly new staff member confirmed they had completed an application form, attended an interview and had not started to work at the home until two references and a CRB check had been taken up and obtained. One person’s application form was seen and appropriately included a request for a full employment history, although any gaps should always be explored and an explanation obtained. However it was not possible to check references and police checks because these documents are held centrally, rather than in the homes. It is recommended that if it is not feasible to keep records on site that a checklist should be kept in the home. This to confirm that satisfactory checks and a fully completed application form have been received, which has been verified by a registered person. This checklist should include details of each staffs starting date, role, contract hours & copies of relevant documents (Reference Schedule 4 Para 6D, e & g of the Care Home Regulations). Staff are expected to undertake all the core health & safety training within six weeks of starting work at the home. Aspire also have an induction checklist they have to go through and they also undertake LDAF induction programme, which is accredited especially for people with learning disabilities. Most staff then move on to do an NVQ qualification in care, and over half the team now have this qualification. It is also good that staff have opportunities to, attend a range of training sessions relating to service users’ special needs e.g. epilepsy, autism awareness and positive interventions for management of challenging behaviours. Most recently a number of staff attended training on dementia. Staff confirm they receive individual supervision from the manager or deputy; have an annual appraisal and they feel well supported. Communication within the team is good, with shift handovers and regular staff meetings held and they feel they are kept well informed and can express their views, which are listened to. They consider staff and managers work well together and the team is committed to providing service users with good care and promoting their quality of life, which the evidence of this and previous inspections supports. Markyes Close 1 & 2 DS0000024681.V325539.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 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including these visits to this service. The home is well run by a suitably experienced manager. There is an open and positive management approach, which helps to ensure that service users’ rights are respected and they receive a good service. Appropriate steps are taken to keep the home safe, for the protection of service users and staff. Systems are in place to monitor and review all aspects of the service. This should result in a plan for the continual improvement of the home, which also includes service users and other involved parties in how the service develops. EVIDENCE: The manager (Mrs Vicki Bace) has over sixteen years experience working with people who have learning disabilities. She started work in the care field as a support worker in a local hospital and when it closed and some patients moved Markyes Close 1 & 2 DS0000024681.V325539.R01.S.doc Version 5.2 Page 23 to Markyes Close she also moved to work there. Subsequently becoming a senior support worker and then the deputy manager. Mre Bace has achieved NVQ level 3 in care as well as attended training courses and sessions in business management , supervision & appraisal, disciplinary procedures and many other care related topics. She has recently started the Registered Manager’s Award (NVQ 4 in care & management) and has a college day each week. This was a condition of her registration as manager, as it is the qualification the Standards now specify for care home managers. Staff and relatives say they feel the home is well run and the administration and management tasks are well organised. This is confirmed in this inspection. The home also receives good support from Aspire who have Human Resource, Training and finance officers as well as other managers and the Chief Executive who can always be consulted. They provide a full range of policies and procedures, which are currently being reviewed and updated corporately. Progress has been made by Aspire to implement a formal Quality Assurance system called PQASSO, which has been designed specifically for use within the voluntary sector. Managers have received training and the manager has been through the processes involved with all the staff. The system covers 12 main quality areas which are needed for a service to run well and achieve good outcomes for service users. They are also appropriately monitored against the National Minimum Standards. Part of the monitoring process is the monthly visits from a representative of Aspire to check how the home is being run. Aspire are working on producing a service user’s involvement policy, to fully involve service users in how the home is run. Questionnaires have been sent to service users and their representatives and in due course a portfolio if evidence will be collated and an annual development plan produced. This plan should outline for a continual development of the service, in line with service users and relevant other people’s wishes. Regarding health & safety in the home Aspire require staff to undertake training in all the mandatory areas, including fire safety, first aid, moving & handling, food hygiene and infection control. Staff confirm they had completed these topics and they are regularly “refreshed”. Aspire also have a Health & Safety officer for the organisation who regularly carries out audits in the home. Certain staff member also have some allocated responsibilities for such as for PAT testing, fire safety and water checks. The pre-inspection information confirmed that the gas and heating installations are service regularly and COSHH risk assessment are in place. Also that fire safety tests and checks are undertaken and drills arranged. There were no safety hazards identified during these visits and the evidence overall indicates that due attention is paid to promote health & safety in the home to promote the welfare of service users and staff. Markyes Close 1 & 2 DS0000024681.V325539.R01.S.doc Version 5.2 Page 24 Markyes Close 1 & 2 DS0000024681.V325539.R01.S.doc Version 5.2 Page 25 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 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 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 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 3 3 X 3 X 2 X X 3 X Markyes Close 1 & 2 DS0000024681.V325539.R01.S.doc Version 5.2 Page 26 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 persons meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered provide 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 to consider carrying out. No. 1 2 Refer to Standard YA19 YA34 Good Practice Recommendations Health Action Plans should be set up for each service user, as a means of promoting their good health. A checklist should be kept in the home for staff confirming the conditions of their employment and that satisfactory checks and references have been received, before their employment is confirmed. This information to have been checked and verified by a registered person. Progress should continue to implement an effective Quality Assurance & Monitoring system for the service. The results of reviews to be reported upon and circulated to participants, relevant stakeholders and the Commission. YA39 3 Markyes Close 1 & 2 DS0000024681.V325539.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Worcester Local Office Commission for Social Care Inspection The Coach House John Comyn Drive Perdiswell Park, Droitwich Road Worcester WR3 7NW 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 Markyes Close 1 & 2 DS0000024681.V325539.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. 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!