Inspection on 31/10/05 for 1 Williams Street

This inspection was carried out on 31st October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 Williams Street 04/11/08

1 Williams Street 14/11/06

1 Williams Street 08/06/05

1 Williams Street 10/11/04

1 Williams Street 28/06/04

1 Williams Street 09/02/04

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Aston Court Nursing Home

Polesworth Group 70 Long Street

Breme

Ravenhurst

Polesworth Group 64 Long Street

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

CARE HOME MIXED CATEGORY MAJORITY ADULTS 18-65 1 Williams Street, Fenton Stoke-on-trent Staffordshire ST4 2JG Lead Inspector Ms Wendy Jones Announced Inspection 31 October 2005 11:30 1 Williams Street, DS0000008217.V252627.R01.S.doc Version 5.0 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 1 Williams Street, DS0000008217.V252627.R01.S.doc Version 5.0 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 Older People and 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. 1 Williams Street, DS0000008217.V252627.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service 1 Williams Street, Address Fenton Stoke-on-trent Staffordshire ST4 2JG 01782 746361 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) Choices Housing Association Limited Mr John Christopher Richardson Care Home 6 Category(ies) of Learning disability (1), Learning disability over registration, with number 65 years of age (6), Physical disability (1), of places Physical disability over 65 years of age (6) 1 Williams Street, DS0000008217.V252627.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 1 - Learning Disability minimum age 43 years Date of last inspection 8th June 2005 Brief Description of the Service: William Street is a purpose built residential bungalow standing in it’s own grounds, the service is operated by Choices. The home provides 24 hour care for six service users with a learning disability, five of whom are over the age of 65 years. Facilities comprise of 6 single bedrooms, which are well decorated and furnished, all have wash hand basins. The lounge/dining area is open plan and spacious, and leads onto a domestic style kitchen, a separate laundry/utility room is also provided.Assisted bathing and shower facilities are provided in addition to two separate adapted toilets. The whole bungalow is accessible to wheelchair users.The rear garden is accessed via a ramp, which has handrails; it has seating areas for the benefit of service users, and appeared well maintained. The front driveway of the property provides off road parking.The home is situated in Fenton, with easy access to the main towns of Hanley and Longton, and is in walking distance to local shops, post office, public houses, take away’s and newsagents. All Primary Health care facilities are within a four-mile radius of the home. 1 Williams Street, DS0000008217.V252627.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection visit carried out 0n 31st October 2005. Information for the report was provided from a pre inspection questionnaire; from discussion with the care manager, deputy manager and staff; from conversation with service users; from observation and inspection of the environment, of service user and staff interactions and care records and other relevant documentation. The service provides for six service users, all have a learning disability, dependency was described as medium to high, five service users were over 65 years of age. One service user was wheelchair dependent, four service users were visually impaired, two of whom were registered blind. Two service users had good verbal communication skills, two service users used gestures or non verbal methods of communicating, two service users had limited verbal communication skills. All service users were male and ages varied from 46 to 80 years. What the service does well: The service had a statement of purpose that gave an accurate description of the service provided. The manager and deputy stated that it was revised on a regular basis. The standard of assessment and care planning was high, with evidence of regular review. Person centred planning had been established, with all service users receiving an annual planning meeting involving the service user, family and other supporters and relevant professionals. Service users were central to the process; each is allocated a key worker who works closely with them to ensure their wishes are respected. Records of health care needs were detailed, with evidence that they were being monitored closely. There was also evidence of multi disciplinary work with health professionals involved with the service users and evidence of positive outcomes for service users. Systems for the management and administration of medication were satisfactory, there were protocols in place for as required medication and evidence of medication reviews. Records for service user occupation and recreational interests were maintained with accompanying records of service user engagement. Service users were offered a balanced diet there was evidence that the service had sought advice from dietetic services. Records indicated that alternatives 1 Williams Street, DS0000008217.V252627.R01.S.doc Version 5.0 Page 6 to the main meal choice were provided. Food stocks were good. Fridge, freezer and hot food temperatures were recorded daily. There was a complaints procedure in place, that had been produced in a user friendly format. The service had demonstrated that any complaints were taken seriously and would be properly investigated. Vulnerable adults procedures were in place, staff had received training in recognising and reporting abuse. The service provided ordinary living for service users in purpose built bungalow, which provided comfortable and pleasant communal and personal space. All bedrooms were for single occupancy, and each of the service users had been supported to personalise their personal space. All bedrooms had lockable facilities, had door locks and appropriate furnishings and fittings. Two service users had their own bedroom door keys. Bathing facilities were adequate with adaptations to meet the needs of service users. Staffing levels were satisfactory, staff confirmed that one to one supervision sessions were up to date, and records showed that staff meetings were taking place. Mandatory training was up to date and additional updates booked. The numbers of staff achieving NVQ level 2 exceeded the minimum of 50 of the workforce. The management arrangements at the home were satisfactory. The registered manager had a nursing qualification and had successfully completed the Registered Care Managers Award. The deputy manager had commenced the RMA and intended to enrol on the NVQ level 4 in care from September 2006. Individual and general risk assessments were in place and were subject to regular review. Fire safety checks were carried out and appropriately recorded, fire training was up to date and fire drills had been carried out very regularly. Health and safety systems were in place, records showed that daily and weekly audits of health and safety matters were undertaken. What has improved since the last inspection? Since the last inspection a new carpet has been fitted in the main hallway and corridor. New flooring had been provided in the shower room and bathroom. A recent recruitment drive has resulted in the employment of additional staff and although they have yet to start, the service will have a full staffing compliment. 1 Williams Street, DS0000008217.V252627.R01.S.doc Version 5.0 Page 7 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. 1 Williams Street, DS0000008217.V252627.R01.S.doc Version 5.0 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Individual Needs and Choices Lifestyle Personal and Healthcare Support Concerns, Complaints and Protection Environment Staffing Conduct of Management of the Home Scoring of Outcomes Statutory Requirements Identified During the Inspection Adults 18 – 65 (Standards 1–5) (Standards 6-10) (Standards 11–17) (Standards 18-21) (Standards 22–23) (Standards 24–30) (Standards 31–36) (Standards 37-43) Older People (Standards 1–5) (Standards 7, 14, 33 & 37) (Standards 10, 12, 13 & 15) (Standards 8-11) (Standards 16-18 & 35) (Standards 19-26) (Standards 27-30 & 36) (Standards 31-34, 37 & 38) 1 Williams Street, DS0000008217.V252627.R01.S.doc Version 5.0 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 (Adults 18 – 65) and Standards 1 – 5 (Older People) are: 1. 2. 3. Prospective service users have the information they need to make an informed choice about where to live. (OP NMS 1) Prospective users’ individual aspirations and needs are assessed. No service user moves into the home without having been assured that these will be met. (OP NMS 3) Prospective service users’ know that the home that they choose will meet their needs and aspirations. Service Users and their representatives know that the home they enter will meet their needs. (OP NMS 4) Prospective service users’ have an opportunity to visit and “test drive” the home. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. (OP NMS 5) Each service user has an individual written contract or statement of terms and conditions with the home. Each service user has a written contract/statement of terms and conditions with the home. (OP NMS 2) 4. 5. The Commission considers Standard 2 (Adults 18-65) and Standards 3 and 6 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 and 3 The homes Statement of Purpose and Service User Guide are good providing service users and prospective service users with details of the services the home provides enabling an informed decision about admission to be made. EVIDENCE: The service has detailed information in the Statement of Purpose and Service User guide providing prospective service users with the detail they require to enable them to make an informed decision about the suitability of the service to meet their needs. The aims, objectives and philosophy of care of the service were explicit and in line with those expected in Learning Disability services. 1 Williams Street, DS0000008217.V252627.R01.S.doc Version 5.0 Page 10 Individual Needs and Choices The intended outcomes for Standards 6-10 (Adults 18-65) and Standards 7, 14, 33 & 37 (Older People) are: 6. Service users know their assessed and changing needs and personal goals are reflected in their Individual Plan. The Service Users health, personal and social care needs are set out in an individual plan of care. (OP NMS 7) Service users make decisions about their lives with assistance as needed. Service Users are helped to exercise choice and control over their lives. (OP NMS 14) Service users are consulted on, and participate in, all aspects of life at the home. The home is run in the best interests of service users. (OP NMS 33) Service users are supported to take risks as part of an independent lifestyle. The service users health, personal and social care needs are set out in an individual plan of care. (OP NMS 7) Service users know that the information about them is handled appropriately and that their confidences are kept. Service Users rights and best interests are safeguarded by the home’s record keeping, policies and procedures. (OP NMS 37) 7. 8. 9. 10. The Commission considers Standards 6, 7 and 9 (Adults 18-65) and Standards 7, 14, and 33 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 8, 9 and 10.(younger adults) 7, 33, and 37 (older people) The standard of assessment and care planning were good. Providing staff with the information they required to successfully deliver care. The systems for service user consultation in this home were good with a variety of evidence that indicates that service users’ views are both sought and acted upon. There was evidence of responsible risk taking, which supported service users rights to live as independently as possible. 1 Williams Street, DS0000008217.V252627.R01.S.doc Version 5.0 Page 11 EVIDENCE: A sample of care records and care plans were inspected during this visit, there was evidence that service users needs had been properly and thoroughly assessed. Care plans and action plans were in place where a specific need had been identified. Reviews of care plans had taken place on a regular basis annual person centred planning meetings had been organised with a six monthly review. Each service user was allocated a key worker, who met with the deputy manager six weekly to discuss the service user care needs and progress. It was reported that service users have opportunities to discuss their preferences in relation to their daily lifestyle. From discussion and observation during this visit it was evident that service user were supported to be involved with day to day decision making in the home. Risk assessments, action plans and protocols to address health care needs were in place, the records showed that there was regular, daily monitoring of these. Following conversation with staff and management it was evident that the needs of service users were known and understood. Care records were appropriately stored in a lockable office. 1 Williams Street, DS0000008217.V252627.R01.S.doc Version 5.0 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 (Adults 18-65) and Standards 10, 12, 13 & 15 (Older People) are: 11. Service users have opportunities for personal development. Service Users find the lifestyle experienced in the home matches their expectations and preferences and satisfies their social, cultural, religious and recreational interests and needs. (OP NMS 12) Service users are able to take part in age, peer and culturally appropriate activities. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. (OP NMS 12) Service users are part of the local community. Service users maintain contact with family/ friends/ representatives and the local community as they wish. (OP NMS 13) Service users engage in appropriate leisure activities. Service users find the lifestyle experienced in the home matches their expectations and preferences and satisfies their social, cultural, religious and recreational interests and needs. (OP NMS 12) Service users have appropriate personal, family and sexual relationships and maintain contact with family/friends/representatives and the local community as they wish. (OP NMS 13) Service users’ rights are respected and responsibilities recognised in their daily lives. Service users feel they are treated with respect and their right to privacy is upheld. (OP NMS 10) Service users are offered a (wholesome appealing balanced) healthy diet and enjoy their meals and mealtimes. Service users receive a wholesome appeaing balanced diet in pleasing surroundings at times convenient to them. (OP NMS 15) 12. 13. 14. 15. 16. 17. The Commission considers standards 12, 13, 15, 16 and 17 (Adults 1865) and Standards 10, 12, 13 and 15 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15,16 and 17.(younger adults) 12,13, 10 and 15. (older people) Service users had access to recreational and occupational opportunities provided, offering a range of experiences. Service user choices regarding engagement in activities were respected. 1 Williams Street, DS0000008217.V252627.R01.S.doc Version 5.0 Page 13 There was evidence from discussion that service users had been supported to retain and maintain contact with family and friends where possible. Service users were supported to access the local community to participate and to be involved in activities of their choice. The standard of menu planning and food choice was good with the special dietary needs of individuals known and catered for. EVIDENCE: Each service user had records of preferred activities and for both in and out of the home. These activities had been agreed at the annual person centred planning meetings. In one example the records showed that a service user should be supported to access local community activities reflective of his age and ability. It was clear from the information available that he did not access these type of activities. The management team stated that activities had been sourced but for a variety of reasons had not been successful. They commented that the service user had not enjoyed the experiences, and the service had concentrated on finding activities for individuals that received a positive response. Activities outside of the home included, a luncheon club for the elderly, enjoyed by a service user on a weekly basis. One service user attended a day service twice per week it was hoped that this would be increased. Service users accessed local community facilities on a daily basis. There was evidence that service users had visited restaurants, pubs, social clubs, the theatre, shops and supermarkets, libraries. None of the service users had received a holiday in the twelve months prior to this inspection, this was reported to be as a result of staffing difficulties and increased health needs of service users. The deputy manager indicated that holiday’s would be planned for 2006. Due to the age and infirmity of some service users they were engaged in fairly passive activities in the home such as listening to music, talking books and watching television, or in hobbies and interests they’d had for some time. One service user was being supported with work, hobbies and interests on his personal computer. Another enjoyed collecting and watching videos of films he had enjoyed in his youth. The service operated a system where service users engagement in activities is recorded daily, the information if then collated to produce statistical information regarding the numbers of activities undertaken by each service user. Staff were provided with a list activities that service user are known to engage in and can help service user to make choices. 1 Williams Street, DS0000008217.V252627.R01.S.doc Version 5.0 Page 14 From discussion with the management team it was established that four service users had no family contact, although efforts had been made to establish contact in the past and continued. One service user was supported to maintain contact by letter. One service user had regular contact with an extended family. Menus were planned over a four-week period, with alternatives to the main meal choice recorded. During the visit one service user stated that he didn’t know what the evening meal choice was. This was discussed with the manager who identified that service users were informed of the choice available to them and that the service was introducing pictorial meal cards to ensure that service users could make informed choices. Fridge freezer temperatures were recorded. Dietetic advice had been sought for individuals and special dietary needs were known by staff and recorded in care records. There was also evidence of regular monitoring of dietary intake and weight loss or gain. 1 Williams Street, DS0000008217.V252627.R01.S.doc Version 5.0 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 – 21 (Adults 18-65) and Standards 8 – 11 (Older People) are: 18. 19. 20. Service users receive personal support in the way they prefer and require. Service users feel they are treated with respect and their right to privacy is upheld. (OP NMS 10) Service users’ physical and emotional health needs are met. Service users’ health care needs are fully met. (OP NMS 8) 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. Service users, where appropriate, are responsible for their own medication and are protected by the home’s policies and procedures for dealing with medicines. (OP NMS 9) The ageing, illness and death of a service user are handled with respect and as the individual would wish. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. (OP NMS 11) 21. The Commission considers Standards 18, 19 and 20 (Adults 18-65) and Standards 8, 9 and 10 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20.(younger adults), 8, 9, 10. (older people) The staff have a very good understanding of the service users support needs this is evident from the positive relationships, which have been formed between the staff and service users. The health needs of service users are well met with evidence of good multi disciplinary working taking place on a regular basis. The medication at this home was well managed promoting good health. 1 Williams Street, DS0000008217.V252627.R01.S.doc Version 5.0 Page 16 EVIDENCE: From observation of interactions; from discussion with staff and management; from conversation with service users and from the records seen. There was evidence that service users personal emotional and physical health care needs were being met. Staff were observed interacting and providing care in a sensitive manner. Service users were consulted about how their care needs could be most appropriately met. Each service user file contained a health assessment the OK Health Check; the assessments were revisited annually in line with Person Centred Planning. There was evidence of frequent health monitoring and appropriate action taken to address any health issues identified. Professional health support was accessed in relation to continence, dietary and epilepsy needs. Access to regular community health services such as dentists and chiropody were recorded. Annual health checks were carried out at the GP’s, including well man checks and routine preventative health checks. Specialist health care input was sourced as required through GP referral. The records for medication administration were appropriately maintained, and signed, there were protocols in place for the administration of as required medication. Records of medication stock control, delivery and return were in place. There was evidence of regular medication reviews. The manager confirmed during discussion and in the pre inspection questionnaire that all staff responsible for the administration of medication had undertaken a certificated medication. An internal assessment of competence had also been carried out. 1 Williams Street, DS0000008217.V252627.R01.S.doc Version 5.0 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22-23 (Adults 18-65) and Standards 16, 18 & 35 (Older People) are: 22. 23. Service users feel their views are listened to and acted on. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted on. (OP NMS 16) Service users’ are protected from abuse, neglect and self-harm. Service users legal rights are protected. (OP NMS 17) Also Service users are protected from abuse. (OP NMS 18) Also Service users financial interests are safeguarded. (OP NMS 35) The Commission considers Standards 12, 13, 15, 16 and 17 (Adults 1865) and Standards 16, 18 and 35 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 (younger adults) 16 and 18 (older people) The service has a complaints procedure in place, which provides service users, relatives and others with relevant information. The Adult Protection procedures were in place provided a robust framework for staff to follow to ensure the protection of service users from abuse. EVIDENCE: The complaints procedure was provided in a user-friendly format and was included in the Service User Guide and Statement of Purpose and displayed in the home. The procedure provided service users, relatives and other visitors with the information they required to enable them to make a complaint or to contact other relevant agencies such as the CSCI and the Ombudsman. No complaints had been received by the CSCI in relation to this home. One complaint had been received by the service and was under investigation at the time of the inspection. 1 Williams Street, DS0000008217.V252627.R01.S.doc Version 5.0 Page 18 Adult protection procedures were in place, providing staff with the information and guidance necessary for them to recognise abuse and to report it. Staff confirmed that training was provided at induction, and that experienced staff had also attended the training that included, guidance on recognising and reporting abuse. The complaint received by the service had resulted in the initiation of vulnerable adults procedures, relevant agencies had been involved in the subsequent investigation, which had yet to be concluded. There was some concern expressed by the management of the home regarding the lack of support received from social service agencies. The Commission for Social Care Inspection are to be informed of the outcome of the investigation. 1 Williams Street, DS0000008217.V252627.R01.S.doc Version 5.0 Page 19 Environment The intended outcomes for Standards 24 – 30 (Adults 18-65) and Standards 19-26 (Older People) are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users live in a safe, well-maintained environment (OP NMS 19) Also Service users live in safe, comfortable surroundings. (OP NMS 25) Service users’ bedrooms suit their needs and lifestyles. Service users own rooms suit their needs. (OP NMS 23) Service users’ bedrooms promote their independence. Service users live in safe, comfortable bedrooms with their own possessions around them. (OP NMS 24) Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Service users have sufficient and suitable lavatories and washing facilities. (OP NMS 21) Shared spaces complement and supplement service users’ individual rooms. Service users have access to safe and comfortable indoor and outdoor communal facilities. (OP NMS 20) Service users have the specialist equipment they require to maximise their independence. Service users have the specialist equipment they require to maximise their independence. (OP NMS 22) The home is clean and hygienic. The home is clean, pleasant and hygienic. (OP NMS 26) The Commission considers Standards 24 and 30 (Adults 18-65) and Standards 19 and 26 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 26, 27, 28, 29, 30.(younger adults) 19, 20, 22, 25, 24, 26 (older people) The home was suitable to meet the needs of service users, with adequate communal space, sufficient bathing and shower facilities and single occupancy bedrooms. The facilities supported the service philosophy of encouraging service users to live as independently as possible. 1 Williams Street, DS0000008217.V252627.R01.S.doc Version 5.0 Page 20 EVIDENCE: The service provided facilities that had been purpose built to accommodate services users of varying needs and abilities. The accommodation was on a single level with widened hallways and doorways. The drive provide parking space for three to four vehicles, the garden and patio area to the rear of the property was accessible to service users, not overlooked and provided a safe area for service users to enjoy. The lounge, dining room and kitchen were open plan in style, providing a spacious and a pleasant communal environment. The kitchen was fully fitted and freely accessible to service users. Since the last inspection new carpet had been fitted in the hallway and the main corridor area. Bathing facilities were provided in a large bathroom and a separate shower room. At previous inspection it had been identified that the bathroom was to be redecorated and adapted to create a more relaxing and welcoming environment for service users. Since the last inspection new flooring has been fitted in both rooms, a further delay has occurred with the previously reported plans to create a sensory bathroom. The manager indicated that the work should be completed in this financial year. An additional wc was located in closer proximity to the lounge and dining room. All bedrooms were for single use, had appropriate furnishings and fittings, and wash hand-basins, all exceeded the minimum standards for spatial requirements. Service users had been supported to personalise and own their rooms. Doors were fitted with door locks. A sample of three bedrooms seen during this visit were pleasant and homely. In two bedrooms it was noted that some repairs to furniture were required, the manager identified that requests for these repairs had been forwarded and would be undertaken during the planned redecoration of service users bedrooms. 1 Williams Street, DS0000008217.V252627.R01.S.doc Version 5.0 Page 21 Staffing The intended outcomes for Standards 31 – 36 (Adults 18-65) and Standards 27 – 30 & 36 (Older People) are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported and protected by the home’s recruitment policy and practices. (OP NMS 29) Service users are supported by competent and qualified staff. Service users are in safe hands at all times. (OP NMS 28) Service users are supported by an effective staff team. Service users needs are met by the numbers and skill mix of staff. (OP NMS 27) Service users are supported and protected by the home’s recruitment policy and practices. Service users are supported and protected by the home’s recruitment policy and practices. (OP NMS 29) Service users’ individual and joint needs are met by appropriately trained staff. Staff are trained and competent to do their jobs. (OP NMS 30) Service users benefit from well supported and supervised staff. Staff are appropriately supervised. (OP NMS 36) The Commission considers Standards 32, 34 and 35 (Adults 18-65) and Standards 27, 28, 29 and 30 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 35 and 36 (younger adults) 27, 28, 30 and 36 (older people). Staff worked positively with service users to improve their whole quality of life. A well-trained, qualified and competent staff team supported Service users. The arrangements for the induction of staff are good with the staff demonstrating a clear understanding of their roles. 1 Williams Street, DS0000008217.V252627.R01.S.doc Version 5.0 Page 22 EVIDENCE: Staffing levels on the day of the inspection were, the manager from 8.30am5.30pm, the deputy 7.30am-5.30pm, one support worker from 7.30am- 5pm. One support worker from 12 noon- 10pm, one from 4pm-10pm and one waking night staff from 9.45pm-7.45am. Preferred staffing levels include two staff through out the waking day with an additional staff at peak times and additional management support. During recent months and as reported at the last inspection the service has suffered some staffing difficulties through staff sickness and vacancies. A recent recruitment drive, has resulted in the vacancies being filled and although the new workers have yet to start. The management were optimistic about the future and acknowledged the restrictions that had occurred during the summer months, relating to the limited opportunities service users had to access the community and have a holiday. The standard of staff training was high, information in the pre inspection questionnaire indicted that all mandatory training was up to date, with updates booked for the next 12 months. This was confirmed from discussion with the management and staff. One member of staff confirmed that the induction she received was of a good standard, two staff confirmed that one to one supervision sessions were undertaken frequently. Levels of NVQ trained staff were reported to be high, with 4 at NVQ level 3, 2 at level 2, exceeding the minimum standard of 50 of the workforce. 1 Williams Street, DS0000008217.V252627.R01.S.doc Version 5.0 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 (Adults 18-65) and Standards 31-34, 37 & 38 (Older People) are: 37. Service users benefit from a well run home. Service users live in a home which is run and managed by a person who is fit to be in charge of good character and able to discharge his or her responsibilities fully. (OP NMS 31) Service users benefit from the ethos, leadership and management approach of the home. Service users benefit from the ethos, leadership and management approach of the home. (OP NMS 32) Service users are confident their views underpin all self-monitoring, review and development by the home. The home is run in the best interests of service users. (OP NMS 33) 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 homes record keeping, policies and procedures. (OP NMS 37) Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. Service users rights and best interests are safeguarded by the homes record keeping policies and procedures. (OP NMS 37) The health, safety and welfare of service users are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (OP NMS 38) Service users benefit from competent and accountable management of the service. Service users are safeguarded by the accounting and financial procedures of the home. (OP NMS 34) 38. 39. 40. 41. 42. 43. The Commission considers Standards 37, 39 and 42 (Adults 18-65) and Standards 31, 33, 35 and 38 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 40, 41, 42 (younger adults) 31, 32, 37, 38 (older people) Service users benefited from a well run and organised home. The manager is supported well by her senior staff in providing clear leadership throughout the home with all staff demonstrating an awareness of their roles and responsibilities. 1 Williams Street, DS0000008217.V252627.R01.S.doc Version 5.0 Page 24 The health and safety of services users was promoted and protected, through appropriate application of policies and procedures. EVIDENCE: The Commission for Social Care Inspection had approved the manager of the service as a fit person, he had a nursing qualification and has managed the service for approximately 12 years. Since the last announced inspection he had completed the Registered Care Managers Award. The deputy manager was undertaking the RMA and intended to enrol on NVQ level 4 in care from September 2006. Information in the pre inspection questionnaire indicated that all equipment in the home had been serviced within the last 12 months, and that policies and procedures required by regulation were in place. Individual and general risk assessments were in place, which included the control measures to reduce the risk and the action required to address risk areas. All were subject to periodic reviews. Weekly fire alarm and emergency lighting checks were recorded; there was evidence of servicing of fire equipment. Fire drills were recorded in sufficient numbers to meet the requirements of legislation and good practice. The records of drills showed that all staff had received regular fire drills Records of monitoring were also in place including copies of Regulation 26 visits on behalf of the provider. 1 Williams Street, DS0000008217.V252627.R01.S.doc Version 5.0 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. Where there is no score against a standard it has not been looked at during this inspection. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 3 4 X 5 x INDIVIDUAL NEEDS AND CHOICES CONCERNS AND COMPLAINTS Standard No Score 22 4 23 4 ENVIRONMENT Standard No Score 24 4 25 x 26 3 27 3 28 3 29 3 30 4 STAFFING Standard No Score 31 X 32 4 33 3 34 X 35 4 36 4 CONDUCT AND MANAGEMENT 37 4 38 4 39 x 40 3 41 4 42 4 43 x Standard No 6 7 8 9 10 LIFESTYLES 11 12 13 14 15 16 17 Score 4 x 3 3 x 3 3 3 3 3 3 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 3 x 1 Williams Street, DS0000008217.V252627.R01.S.doc Version 5.0 Page 26 no Are there any outstanding requirements from the last inspection? 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. Refer to Standard Good Practice Recommendations 1 Williams Street, DS0000008217.V252627.R01.S.doc Version 5.0 Page 27 Commission for Social Care Inspection Stafford Office Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES National Enquiry Line: 0845 015 0120 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. 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