Inspection on 10/09/08 for 1 Abell Gardens

This inspection was carried out on 10th September 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 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

1 Abell Gardens 22/09/06

1 Abell Gardens 16/11/05

1 Abell Gardens 14/06/05

1 Abell Gardens 28/01/05

1 Abell Gardens 18/10/04

1 Abell Gardens 10/02/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 30/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 1 Abell Gardens Furze Platt Road Maidenhead Berkshire SL6 6PS     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Helen Dickens     Date: 1 0 0 9 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 32 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 32 Information about the care home Name of care home: Address: 1 Abell Gardens Furze Platt Road Maidenhead Berkshire SL6 6PS 01628789658 Telephone number: Fax number: Email address: Provider web address: 1abell.gdns@owl-housing.org Name of registered provider(s): Name of registered manager (if applicable) Miss Susan Gilbert Type of registration: Number of places registered: Owl Housing Ltd care home 6 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 6 The registered person may provide the following category/ies of service only: Care home only - PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning disability - LD Date of last inspection Brief description of the care home 1, Abell Gardens is a single story purpose-built care home situated in a quiet residential road on the outskirts of Maidenhead. Owl Housing Ltd, a non-profit making charitable society is registered to provide accommodation, support and personal care for up to six younger adults who have learning and physical difficulties. Accommodation is provided in single bedrooms. The bungalow has a secluded rear garden, recently redesigned, that is for use by the residents of the property. There are a limited number of car parking spaces on the property and in the access road. 6 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 32 Brief description of the care home Care Homes for Adults (18-65 years) Page 5 of 32 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This key inspection was unannounced and took place over 7 hours. The inspection was carried out by Mrs. Helen Dickens, Regulation Inspector. The Registered Manager was on leave and therefore the Senior Care Worker, and later the Deputy Team Leader, represented the service. A full tour of the premises took place and a number of documents and files, including three residents assessments and care plans, staff recruitments files, quality assurance information, and the annual quality assurance assessment (AQAA) were examined as part of the inspection process. A number of questionnaires returned to CSCI about this service were also considered in writing this report. Care Homes for Adults (18-65 years) Page 6 of 32 The current fees are 1671 pounds per person per week. What the care home does well: What has improved since the last inspection? Since the last inspection in September 2006 a number of improvements have been made. The home has met the previous Requirement to ensure that temperatures of hot meals are recorded, and that fridge and freezer temperatures are monitored. A Recommendation to up-date the hazardous substances risk assessments (mainly cleaning fluids) has been done in some detail and the staff member who had been working on this said it is kept under review to include any new products. In addition some bedrooms have been re carpeted and decorated and one has been completely refurbished. A new lounge carpet has also been fitted. Extensive work has been carried out on the redesigned garden. Some features are already in place such as the curved pathways, a permanent barbecue, and a new water feature. The plants and sensory area, and further seating will be completed in the next phase. Opportunities for activities continue to improve and some service users have now been Care Homes for Adults (18-65 years) Page 8 of 32 introduced to more outward bound activities, including sailing. One resident has also been camping. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 32 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 32 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents individual aspirations and needs are assessed prior to them moving in to this home. Evidence: Three residents files were sampled during the inspection. Two residents had been at the home for some years and their original assessments had been archived. A third file looked at was that of a new resident and this contained all the necessary pre admission assessments. This included information collected under headings such as What people like about me and First important things. Health needs were noted, for example in relation to allergies. Personal care was well documented including What people need to know to support me. Staff spoken with were knowledgeable on residents needs and the deputy team leader was particularly well informed about the new resident, and how the transition to Abell Gardens had been made. The home had liaised closely with this residents family and trial visits to Abell Gardens had been arranged. The homes AQAA states that there is an admissions policy and procedure in place and an accessible version of their Service User Guide. Care Homes for Adults (18-65 years) Page 11 of 32 Care Homes for Adults (18-65 years) Page 12 of 32 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents assessed and changing needs are reflected in their care plans, and they are encouraged to make decisions in their daily lives. Residents are supported to take risks in their daily lives though more work is needed to ensure all known risks are assessed and minimised. Evidence: Three residents files were sampled and found to contain detailed information on all aspects of residents care and support. Link workers were very knowledgeable on the support each resident needed and there were good guidelines in place for staff. Specialist advice had been taken where necessary and residents ongoing needs were monitored and recorded. Each resident has a Quick Reference Guide which sets out their needs clearly and briefly, giving an overview of the support they need. This is useful for new staff or if the home need to use agency or bank staff. There were copies of the 6 monthly care Care Homes for Adults (18-65 years) Page 13 of 32 Evidence: reviews on file and these were very detailed and showed the progress each resident had made. One relative was interviewed during the inspection and they said they had been visiting the home for over a decade. They were full of praise for the home and staff, and told the inspector how well their relative was looked after. I honestly cant fault it. Staff have got to know her and they make sure her teeth are always clean and her hair is lovely and soft. And she has no end of clothes. One resident still needed to have their file organised into the person centred format as the other files already are. The link worker for this resident was very knowledgeable about their needs in relation to personal and health care support, and could find their way around the file to demonstrate that all the necessary information was in there. However, others would find it difficult to access this file and it is recommended that more progress is made with regard to the person centred format. Residents are encouraged to make decisions in their daily lives for example in relation to the activities they participate in, the decor in their rooms, and their meals. During the tour of the building the senior care worker described how residents had been involved in the refurbishment of their rooms, and how their bedrooms reflected their interests and personalities. Staff were observed to communicate well with residents though most residents at this home find it difficult to make choices, therefore records showed choices residents had made in the past, and preferences were noted to inform future support. Good guidelines are in place at this home to enable staff to support residents safely. For example in relation to activities such as using the trampoline and going swimming. All residents who use transport had guidelines in place, and moving and handling risk assessments were noted on residents files. There were also detailed guidelines in relation to health conditions for example epilepsy, and for eating and drinking to avoid choking. However, more risk assessments were needed in relation to the laundry room which is not locked, and various personal toiletries such as bubble bath which are in residents rooms, which are also unlocked. The deputy manager completed these risk assessments and therefore no Requirement was made. During the inspection it was noted that the key was missing for the cleaning liquids cupboard which was unlocked. The deputy team leader had the items moved to a lockable cupboard elsewhere until either the key could be found or a new lock fitted. The deputy team leader, whilst agreeing the concern was justified, said no residents would be able to access the cupboard as only one can walk unsupervised and they would not go into a room, nor Care Homes for Adults (18-65 years) Page 14 of 32 Evidence: could they open a cupboard. The inspector pointed out that the home also need to consider any visitors to the home who may be at risk, for example other people with learning difficulties, or children. The shortfall was rectified immediately but a review of current monitoring arrangements is needed to ensure the homes staff are always vigilant and any shortfalls rectified in a timely fashion. Care Homes for Adults (18-65 years) Page 15 of 32 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents have opportunities to take part in fulfilling activities and to be part of the local community. Family and friendship links are encouraged and residents are treated respectfully by staff. The home encourages residents to have a healthy diet and their likes and dislikes are taken into account when staff plan the menus. Evidence: Residents at this home have the opportunity to take part in meaningful and enjoyable activities. All three files sampled showed residents preferences in relation to activities and those currently on offer included trampolining, swimming, sailing, bowling, music, cooking, aromatherapy, talking books, and personal shopping. One resident attends the gym, and another goes to ice hockey matches when their favourite team plays at home; a timetable of the teams fixtures for the year is on the office wall. There is guidance for staff on objects of reference as mentioned earlier, and each resident has Care Homes for Adults (18-65 years) Page 16 of 32 Evidence: a laminated card with their weekly activities. There are separate records for activities at Day Services. Staff said all the residents attended the Owl Summer Ball which was held recently. Monthly Link worker meetings are held to review the activities and goals for each resident. Staff are always on the look out for new activities and on the afternoon of the inspection had identified companion cycling (which they were then researching on the internet) which they thought might be an enjoyable new experience for some residents. Residents are encouraged to be part of the local community and the activities noted above demonstrate this involvement, for example the talking books come from the local library, and some residents belong to the disabled sports association. All residents attend local day services and use local health facilities. The staff said they are trying to set up a local bowling league in the evening as four residents now go bowling on a regular basis. The relative who was interviewed during the inspection said that the relative they visited was taken out a lot, attended day services and the local leisure centre, and had had a holiday. Residents are supported to maintain family and friendship links and emotional well being is part of their person centred plan. Staff are knowledgeable on family involvement and gave several examples of where they had been very involved with residents families. The relative who was interviewed on the day of the inspection had only praise for the home and staff. She is a regular visitor who has been coming to the home for over a decade so had a good knowledge of the routines and atmosphere in the home. When asked what she thought about the home she said I honestly cant fault it. There is a relationship map on each residents file showing important people in their lives, as well as a pictorial family tree, and a record of important family birthdays. Daily routines are flexible and staff were observed to be respectful to residents. Each residents preferred form of address was noted on their file and heard being used by staff. This was happening not just when addressing the resident but when talking about them. For for example one resident was on holiday but when staff spoke about him they used the preferred form of address noted on his file. Staff were observed to interact well with residents and included them in conversations, even though most residents at this home have little or no verbal skills. Residents can choose to be alone or in company and all had very individual and comfortable bedrooms to retreat into if needed. Some had chimes, special lighting, and their own music, with relaxing colour schemes and accessories. Privacy lights are fitted outside the toilet and bathroom so that staff know if the room is occupied and dont have to keep disturbing the occupant to check if it is in use. Care Homes for Adults (18-65 years) Page 17 of 32 Evidence: Residents at this home cannot easily make food choices and staff said menus are based on their knowledge of past favourites and the likes and dislikes (and allergies) noted on each care plan.The AQAA said residents are supported to plan well balanced meals, and menus are also discussed at tenants meetings and at handover. One resident was noted to have a very complicated regime for their meals and their relative said the home managed this well. There are guidelines for staff in relation to supporting residents to eat and drink safely, and especially detailed for those at risk of choking. On the day of the inspection residents had fresh soup for lunch and a home made chili con carne and baked potatoes for supper. There was a pleasant aroma coming from the kitchen during the late afternoon and residents were later observed to be enjoying their meal. The deputy manager said most of the suppers are home made and some staff are very good at cooking. Care Homes for Adults (18-65 years) Page 18 of 32 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this 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 personal care in the way they prefer and their health needs are met. They are protected by the homes policies and procedures for dealing with medicines. Evidence: Residents needs in relation to personal support are well documented on their files. These include how they wish to receive personal and health care support and sets out their preferred routines. The AQAA states that each service users person centred plan is used to promote their needs and wishes. Personal care is provided in private and there are privacy lights on the toilet and bathroom as mentioned earlier. Residents were observed to be dressed very individually, reflecting their personality. One relative said staff paid close attention to the personal care of the relative she visited, and said they had No end of clothes. There was evidence of residents being given a choice regarding the gender of their care worker, for example one resident had just gone on holiday with a care worker of the same gender. Technical aids and equipment are available, including hoists as required by each service user. Specialist advise is taken as necessary e.g. speech therapists, and physio and occupational therapists. The home has a link worker system and link workers meet on a monthly basis to discus the Care Homes for Adults (18-65 years) Page 19 of 32 Evidence: needs and progress of their residents. One link worker was interviewed and found to be very knowledgeable on all the needs and preferences of the resident they worked with. It was noted that good relationships have developed between the home and family members who wish to be involved in care of residents. One residents file sampled was not in the person centred format and more work needs to be done on this; a Recommendation has been made under Standard 6. Residents health care needs are assessed and there are good records of health appointments, interventions and guidelines for staff. For example the special arrangements made for one resident in relation to receiving dental treatment. There are risk assessments and guidelines for particular health conditions such as epilepsy, including seizure record sheets.Specialist referrals and assessments are made as necessary and recorded for example one file showed interventions by a psychiatrist. The emotional well being of residents is looked at as part of their person centred plan, and the new format the home is currently introducing has a section entitled To keep me healthy and safe. One relative said the staff recognised health problems e.g. their relative was prone to earache and the odd cold, and this was dealt with well by the staff. It was noted that one resident was on a weight reducing diet and has their own freezer where special low fat meals are stored; these are home cooked by one of the night staff. There are good guidelines for staff on as required medication to ensure these are being given appropriately and in a consistent way. The home ensures residents have opportunities to maintain their health by exercise and it was noted that some belong to the disabled sports association. Another goes to the gym and to trampoline sessions. There are also therapeutic opportunities and several residents attend sensory sessions at the local leisure centre, and have aromatherapy. The garden currently being developed at the home will have sensory areas with special lighting, a water feature and shaded seating areas for relaxation outdoors when the weather is fine. A therapist who visits service users at this home said the home Encourages service users to be active....and involves other service providers when they are unsure. Medication comes from the local pharmacy using the Monitored Dosage System. There is a medication policy in place and the AQAA states that Medication is administered following policy and procedure and in the way service users prefer. One medication session was observed and found to be satisfactory. It was noted that the medication was administered sensitively by staff according to the special needs of each resident. Medication was stored securely and a shortfall already noted and reported by staff in relation to storage was followed up again by them during the inspection. The Controlled Drugs cupboard was checked and no discrepancies were found. Two medication records were sampled and no unexplained gaps were found. Residents files Care Homes for Adults (18-65 years) Page 20 of 32 Evidence: showed a good overview of health and medication requirements. The community pharmacist visits the service from time to time to check their medication administration arrangements but the last report was not available. The deputy manager was asked to follow up on on this. Care Homes for Adults (18-65 years) Page 21 of 32 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this 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 complaints would be taken seriously, and they are protected from abuse. Evidence: The AQAA states that No concerns or complaints have been lodged. The complaints procedure is attached to the Statement of Purpose and Service User Guide. A more accessible format is available but the AQAA states that they have not been able to develop a version which would be user friendly to the current group of residents. Staff were observed to communicate well with residents and during the inspection there was an example of one resident who appeared to be concerned about something but was not able to tell staff. Staff were knowledgeable on this residents preferences and were very patient in observing and interacting with the resident until they could work out what was needed. No complaints have been received to CSCI about this service in the last 12 months. The AQAA states that Staff have received training on protection of vulnerable adults. and there is an in-house policy in place. No safeguarding adults matters have been raised in the last 12 months. Recruitment procedures are shared with head office and a proforma is kept on file at the service to show all the relevant checks had been carried out. The inspector also asked to see evidence of proper recruitment checks for the agency member of staff who was working on the day of the inspection. The service had a detailed record of all the checks that had been carried out, and all the training Care Homes for Adults (18-65 years) Page 22 of 32 Evidence: this member of staff had had to date. Such thorough recruitment checks safeguards residents. The deputy team leader was asked about the procedure to be followed in the event that a report of abuse was made. She was knowledgeable on what actions to take. The home did not have the latest version of the local authority procedures for safeguarding adults and the deputy team leader was asked to follow this up, and obtain a summary version which can be handed out to staff. Residents at this home all have their own bank accounts with two signatories are needed to withdraw money. They all have either a purse or a wallet and these are kept securely at the home. The amount of cash in each is checked 3 times daily at shift hand overs. Receipts are kept on file for all transactions. The deputy team leader audits these accounts fortnightly and a random selection are checked at the monthly Regulation 26 visits. Care Homes for Adults (18-65 years) Page 23 of 32 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. I, Abell Gardens offers a very homely environment which is clean and hygienic throughout. Evidence: 1, Abell Gardens offers a very homely and comfortable environment for residents. There is a large lounge overlooking the garden and a separate dining room. There is a large domestic style kitchen and and all areas of the home visited were bright and well furnished. The inspector went into every bedroom and found these to be very individually decorated and furnished. Staff said bedrooms reflected the colours and preferences of each resident for example one person who was quite traditional in their tastes had cream furniture with brushed pewter antique handles, matching blinds, their own sofa and cream and rose painted walls, displaying family photos and prints. This resident also had their own music collection including a variety of CDs showing their preferences for both easy listening and rock music. Another resident had cream and brown decor with matching furniture, a large model yacht, a dream catcher and large wall mounted sheepskin brought back from last years farm holiday. Staff should be commended for the time and effort they have put into ensuring residents rooms Care Homes for Adults (18-65 years) Page 24 of 32 Evidence: reflected their individual styles and every room was noted to provided a comfortable and enjoyable alternative venue during the day, and a restful private space at night. One relative interviewed said they were pleased with the bedroom for their relative which again was very personalised. This resident had a made to measure rocking chair in their bedroom, and a very comfortable garden swing brought in by the family. Adaptations such as wide doorways, ceiling hoists and special adaptations had been made to some toilets. Privacy lights outside the toilet and bathroom ensured staff knew when these rooms were being occupied. The bathrooms and toilets were also nicely decorated, though some notices displayed for guidance to staff looked rather institutional, and one related specifically to a resident; the staff member accompanying the inspector removed these notices and said their use would be reviewed. There is major work being done on the garden which is now purpose built and designed with these residents in mind. The paving is already in place and there is a proper barbecue, an outdoor rocking bed and a garden swing. The water feature has now been built and some of the large plants have been placed. The next step is to plant the smaller flowers and bushes. The garden design and labour has been donated by a relative of one member of staff who is not charging for their time, and the plants are being donated by Farnham Common Nursery. There are good hand washing facilities throughout this home and gloves and aprons are readily available. There are washable floors in the bathrooms and laundry and a daily list of cleaning for staff on duty. The home was clean and fresh smelling throughout. The shortfalls in relation to the cupboard in the laundry room, used to store cleaning materials, are discussed under Standard 9. Care Homes for Adults (18-65 years) Page 25 of 32 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this 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 supported by competent staff and there is a thorough recruitment procedure in place. Training and development arrangements at this home ensure residents needs are met. Evidence: The staff at this home were observed to be approachable and sensitive to residents needs. In some cases they anticipated residents needs, and in others they worked hard, using their existing knowledge of the resident, to ascertain what was needed. One relative described how the person she visited sometimes had minor health worries like earache, and staff had now got used to this and knew when it was a problem. Staff were noted to communicate well with residents and followed the detailed written guidance about how they should communicate with individual residents at the home. Three staff were interviewed, and they all demonstrated excellent knowledge of residents needs and preferences. Five of the current twelve staff have NVQ Level 2 or above qualifications in care, and two others have started this course and expect to complete it next year. Recruitment is shared with head office and the files of three staff members on duty were checked. Two were permanent staff and proformas were in place confirming all Care Homes for Adults (18-65 years) Page 26 of 32 Evidence: had had the correct checks carried out. The third person was from an agency. The service has arranged with the agencies that they use a proper handover sheet which is completed for each agency member of staff working at this home. One was sampled and it confirmed the CRB check had been carried out, and had the CRB number, as well as confirmation that references, ID, and work permit details had all been checked. Training certificate results were noted, and there were a further three written paragraphs on the training and skills of this worker. There is a staff training programme in place and training records were available for inspection. The AQAA states that new staff receive a thorough induction and staff are encouraged to source training they feel would benefit service users. Files showed staff had a good range of both mandatory and specialist training. Owl has its own rolling programme of staff training and this ensures initial and refresher courses can be booked in a timely fashion. Surveys returned to CSCI made some positive comments on the skills and training of staff. One staff member noted that The service offers a wide range of training which is much needed to meet the ever changing needs of service users. Care Homes for Adults (18-65 years) Page 27 of 32 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. This home is well managed and there are arrangements in place to monitor the quality of the service provided. The safety and welfare of residents is promoted at this service. Evidence: The management arrangements have not changed since the last inspection and the same manager has been in post for four years. She is qualified to include the Registered Managers Award. Though she was on leave on the day of the inspection the home was being well run with clear lines of responsibility among the staff team. The deputy team leader and senior staff assisted the inspector and demonstrated a very professional and open approach to the inspection process. There are a number of arrangements in place at this service to ensure the quality of the service is maintained and improved. Owl Housing has a quality assurance policy which staff follow, and there are monthly Regulation 26 visits on behalf of the provider. There are regular tenants meetings and staff team meetings. Staff said tenants meetings follow a set format to include menus, activities, and any concerns. Care Homes for Adults (18-65 years) Page 28 of 32 Evidence: As the majority of tenants are not able to verbally express their wishes, staff follow guidelines and use their existing knowledge of residents preferences at these sessions. There are monthly Link worker meetings to ensure that goals and objectives for each resident are being monitored. Care plans are thoroughly reviewed every 6 months and good examples of this were seen on the day of the inspection. When asked about an annual development plan, the deputy manager described progress on the plan that is currently being put together by the management team. The deputy team leader said that a new member of staff is now taking the lead on health and safety at the home and they have already highlighted a number of issues including rearranging one bedroom to improve safety for staff and resident. Owl Housing also has a member of staff responsible for this and internal checks are done up to 4 times per year. Legionella safety checks are carried out and staff said water temperatures are checked and thermostats are fitted to basins to prevent scalding. Gloves and aprons are readily available for staff. Hoists are serviced 6 monthly to ensure they are kept in good working order. The AQAA states that the deputy team leader Is one of the trainers for manual handling and delivers this training for the organisation. The issue regarding the cupboard in the laundry is discussed under Standard 9. The AQAA also states that Fire safety equipment is serviced regularly and fire tests and drills are recorded and take place within the service on a regular basis with risk assessments in place. The deputy team leader said fire evacuation arrangements are being reviewed urgently following a communication from the fire service; it will now be up to staff to evacuate residents in the event of fire and therefore the current night time arrangements in particular will need to be reviewed. Care Homes for Adults (18-65 years) Page 29 of 32 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 30 of 32 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 9 13 A review of current risk 17/10/2008 assessments and safety arrangements must be carried out as outlined under Standard 9. To ensure the health and welfare of residents and reduce any unnecessary risks. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 6 It is recommended that more progress is made on the person centred planning format to ensure all residents have a well organised and accessible plan for the support they need. The home should obtain the latest copy of the local authoritys Safeguarding Adults Procedure. 2 23 Care Homes for Adults (18-65 years) Page 31 of 32 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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