Inspection on 28/04/08 for Priory Highfields

This inspection was carried out on 28th April 2008.

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

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

Other inspections for this house

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 20/07/2008.

CARE HOME ADULTS 18-65 11 Highfields Road 11 Highfields Road Chase Town Staffs WS7 4QR Lead Inspector Mandy Brassington Key Unannounced Inspection 28th April 2008 10:00 11 Highfields Road DS0000071129.V363071.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 11 Highfields Road DS0000071129.V363071.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. 11 Highfields Road DS0000071129.V363071.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 11 Highfields Road Address 11 Highfields Road Chase Town Staffs WS7 4QR 01543 672173 01543 672173 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) www.prioryeducation.com Priory Education Services Ltd Miss Stephanie Gee Care Home 3 Category(ies) of Learning disability (3) registration, with number of places 11 Highfields Road DS0000071129.V363071.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care Home Only (Code PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the folllowing categories: 2. Learning Disability (LD) 3 The maximum number of service users to be accommodated is 3. Date of last inspection New Service Brief Description of the Service: Highfields is a modern home, accessed by double iron gates. There is one other house within the enclosed grounds, owned by the company. The acting manager reported that the second home is to provide a similar service later within the year. The home is an ordinary domestic house and is able to accommodate three people with a learning disability. On the ground floor there is a large lounge area leading to a dining room, which also contained activity equipment and musical instruments. There are patio doors into the garden, which is secure. The garden is grassed with established trees and plants. The kitchen is fitted to a good standard and there is a dining area, which is used when people prepare their meals and eat together at meal times. There is a single toilet for use by all people. On the first floor there are three bedrooms, one of which is en-suite. There is a bathroom with a separate shower cubicle. All bedrooms are personalised by individuals to reflect their interests. There is an office on the first floor. There is a separate double garage, part of which had been converted to a utility area. 11 Highfields Road DS0000071129.V363071.R01.S.doc Version 5.2 Page 5 The home is managed under the principles of Daily Life Therapy. People at the home have used this therapy at a local School, also managed by the Priory Group. The home has been developed to provide people with needs on the Autistic Spectrum Disorder, to be able to continue the therapy and develop skills for independent living. The Service User Guide on 28 April 2007 recorded that the weekly fee level for the home was between £2,928 and 3,700, which included additional funded one to one hours. The acting manager confirmed this to be accurate. This information was correct at the time of this inspection. The reader may wish to contact the service to establish the current fees. 11 Highfields Road DS0000071129.V363071.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use the service experience good quality outcomes. This visit was an unannounced key inspection and therefore covered the core standards. This was the first inspection of the service, which was registered in December 2007. The inspection took place over 7.5 hours by one inspector who used the National Minimum Standards for Younger Adults as the basis for the inspection. Prior to the inspection, the acting manager completed an Annual Quality Assurance Audit (AQAA) for us. There were questionnaires sent to people who use the service, professionals and staff members. Due to the complex needs of people using the service we were not able to gain the views of people using the service on the visit. Discussion took place with two relatives at the home. A tour of the home was undertaken. On the day of the inspection, the home was accommodating two people. We, the commission examined records, carried out indirect observation of two people who used the service, and four staff on duty. Two care plans and three staff records were examined and observation of daily events took place. We joined the people who used the service and staff on a grocery shopping trip to a local supermarket. Inspection of the storage system and medication procedures were inspected. What the service does well: People who live at the home previously attended Horizon School, which is also managed by the Priory Group. The home has been opened to provide children with an opportunity to continue with the Daily Life Therapy into adulthood and provide continuity of care. A number of the staff team supported people at the school and have moved to the home to continue this support. 11 Highfields Road DS0000071129.V363071.R01.S.doc Version 5.2 Page 7 Staff receive a thorough induction to the home and the principles of Daily Life Therapy for two weeks, and are then supervised for two further weeks to support them to implement the therapy and work consistently with everyone. Each person has a plan of care, which they helped to develop. People living in the home need support to communicate with others and a video of their ultimate ‘dream’ and how they are planning to achieve this was made. The plan also includes small targets to work towards completing their dream. People are involved in a variety of leisure and work activities including, working at a park, at a stable, a charity shop and a pub. Daily Life Therapy focuses upon exercise as a way of channelling energy. People usually start the day with jogging around the park or swimming, and both people are members of a local gym. Each activity has been risk assessed prior to taking part, including how many staff are needed to support each person. People regularly eat out in the community or go bowling and watch football matches of the local team. Key workers support people to identify what activities they want to be involved in on a daily basis. Daily Life Therapy is structured to support people who have been assessed on the Autistic Spectrum Disorder, but now people have become an adult, the therapy is more flexible and supports people to make decisions about their life and how to live each day. People are able to develop life skills, to complete domestic chores in the home, and take responsibility for shopping and cooking. Staff are committed to supporting people to achieve identified goals. Due to the complex needs of people using the service, staff have been flexible and inventive at planning and enabling activities to take place, so that people have access to ordinary activities within the local community. An example of this is how everyone is supported to go out for meals, and food is prepared prior to the event but served by catering staff. Family continue to play a big part in people’s lives, and visit the home or people stay with family members. Staff support people to keep in touch through the internet or by phone or letter. What has improved since the last inspection? This was the first inspection of the home, as it was registered in December 2007. 11 Highfields Road DS0000071129.V363071.R01.S.doc Version 5.2 Page 8 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. 11 Highfields Road DS0000071129.V363071.R01.S.doc Version 5.2 Page 9 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 11 Highfields Road DS0000071129.V363071.R01.S.doc Version 5.2 Page 10 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, 4, 5. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Admissions to the home only take place after a comprehensive assessment. People are able to spend time in the home and visit on many occasions before deciding whether to move in. EVIDENCE: The home was registered in December 2007 and two people were identified as meeting the criteria for admission to the home. The home was developed to provide a continuing service to people from a local school, managed by the Priory Group, which specialises in Daily Life Therapy. The two people were assessed through the Care Management Process, a copy of which was available at the home. The assessment focused on achieving positive outcomes for people and how the home could provide a suitable service. People have a copy of the Statement of Purpose and Service user Guide, which has been developed with pictorial support. The Guide includes details of the terms and conditions of occupancy and fee level. Staff reported that the Guide was discussed with both persons to support understanding. 11 Highfields Road DS0000071129.V363071.R01.S.doc Version 5.2 Page 11 Individuals were able to visit the home over several months. Prior to the home opening, people were given an opportunity to participate in choosing suitable furnishings, the colour and furniture for their bedroom. A number of staff previously worked at the school and transferred to the home to ensure continuity of care and support for people. We discussed the choice of home with the parents of one person, who reported they visited many homes, but chose this home as their family member had been working under the framework of Daily Living Therapy for many years, and was comfortable with this. The person already knew a lot of the staff, as a number of them moved from the school to the home, providing continuity of care. Daily Living therapy is reported ‘to focus on the person’s potential, builds on people’s achievements and develops their potential for independence’. 11 Highfields Road DS0000071129.V363071.R01.S.doc Version 5.2 Page 12 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 excellent. This judgement has been made using available evidence including a visit to this service. The care plan is developed with, and owned by the individual. The plan is individual to the person and focuses on strengths and personal preferences. With support, the person is helped to understand the information in the care plan, which is regularly reviewed. EVIDENCE: Each person has a detailed person centred plan, which includes information about personal history and family, the person’s usual routine, and a personal profile, including how to understand moods and behaviour. The plan is completed with the person and focuses on the Principles of Daily Living Therapy. Working with the Key worker and family, the person is able to identify a ‘dream’ and what they aspire to in the future. The acting 11 Highfields Road DS0000071129.V363071.R01.S.doc Version 5.2 Page 13 manager recorded in the AQAA that ‘the dream is what the person’s hopes and aspirations are for the future. The plan is a collection of targets and steps needed in order to achieve the dream’. Staff confirmed this stating ‘the person is supported to meet achievable targets towards the end dream’. People who use the service require support with communication and each person made a video of their dream, and how this was to be achieved. The video and the plans of care are to be reviewed within six months. Information relating to the person’s culture and religious needs is included in the plan, and how these are to be met. People at the home are able to express their own sexuality and individual sexual development is supported. A nursing care plan records strategies to support staff to manage any behaviour, including what to say. All behaviour is recorded and reviewed with the plan of care. Information regarding triggers to any known behaviour, what may upset a person, or known fears is also included within the plan. Personal risk assessments record the identified levels of risk and how to support the person. Assessments cover traffic awareness, self-harming, travelling in vehicles, sexual activity and cooking. Each person has a Life Story; this was started at school and is continued within the home. The book records information about friends, family, personal interests and activities. Photographs of people and places visited, along with a record of likes and dislikes, and how they felt are included. People are supported to make decisions about all aspects of their life. Discussion with staff and family members, and examination of the plans revealed that both people were assessed on the Autistic Spectrum Disorder and therefore choice and changes have to be carefully managed. Within the AQAA the acting manager recorded that ‘choices made were recorded daily on the young person’s individual’s record which is also used as a prompt for staff to keep choice and decision making at the forefront of their work with the young adults’. Observation of practices and discussion with staff demonstrated that people are able to make valuable and informed choices throughout the day. During the shopping trip, one person was observed choosing his own food, including the type and brand. 11 Highfields Road DS0000071129.V363071.R01.S.doc Version 5.2 Page 14 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 excellent. This judgement has been made using available evidence including a visit to this service. People can make choices in all areas of their life and have opportunities to work and join in with social and recreational activities. Personal relationships are encouraged and people are able to develop and maintain existing relationships. EVIDENCE: The Plans of care records individual preferences, usual routines and how people are able to communicate. The Plans are reviewed every three weeks with the person and Key worker, to ensure the information is accurate and to reflect any changes. The plan also records details about the person’s ‘dream’. This includes recording choices about life style and activities. 11 Highfields Road DS0000071129.V363071.R01.S.doc Version 5.2 Page 15 The home is managed to support people in line with ‘Daily Living Therapy’. This includes a meeting with staff and people who use the service near the beginning of each shift. The day’s events and activities are discussed and a daily plan developed for each person. The therapy focuses on physical activity and people are supported to participate in jogging or swimming to start each day. People practice the Daily Therapy ‘postures’, which are physical postures that people can do to help manage anxiety. Staff reported that people occasionally need to be prompted to use the ‘postures’, though as they have used this therapy for many years at the school, they are more able to recognise how they are feeling. On the morning of the visit, one person was supported by two staff to work at a local charity shop, and one person was completing household chores. After lunch, both people were supported to complete the weekly shopping. A fourweek menu was used with a shopping list to assist people identify which food products were needed in each recipe. Staff were observed helping people to make choices about food products and take an active role in the shopping. Discussion with staff and inspection of records revealed that people have access to a wide variety of activities. In the home, there is a computer games console and a computer, music equipment and crafts. The acting manager reported that a lot of activities are based on music, sometimes people concentrate on the rhythm of music and at other times people make music. There are a number of musical instruments including a keyboard and mini steel drums. All activities in the community have been risk assessed. Staff reported that due to the complex needs of people who use the service all activities are assessed prior to any outing or activity. The risk assessments include information about the directions, the main purpose of activity, hazards and facilities; time to be allocated, initial preparation, admission charges, and a summary of risks. People have access to a variety of activities and work placements in the community including horse riding, and horse and stable care, working in the park, gardening and maintaining the park, and working in a pub setting tables. Leisure activities include going to the gym, swimming, eating out, shopping, bowling and attending local football matches. One person attends Mass at a local Catholic Church every week. Within the AQAA the acting manager reported that ‘family and friends are actively encouraged to visit and spend time at Highfields, and people telephone family and/or friends several times per week and have their own phone line for personal calls’. Staff and family members confirmed this. On the day of the visit family members visited one person and commented that their son had been away on holiday with them for six weeks. They reported 11 Highfields Road DS0000071129.V363071.R01.S.doc Version 5.2 Page 16 that staff at the home ‘always keep us up to date with everything and we can visit whenever we like’. Further discussion revealed that staff offer support to enable the principles of Daily Life Therapy to be continued at home. Family members commented that they are confident that they have the knowledge to practice this therapy, though in a more relaxed manner at home. They reported ‘our son is always happy to come back here, if he didn’t like it he wouldn’t want to come back.’ The plans of care record people’s likes and dislikes with food. One person has a specific intestinal intolerance, which means there is a very strict list of organic products that can be used. Medical assessments have been carried out since childhood and the staff continue to work closely with family and health care professionals to ensure that only appropriate foods are eaten. Due to the intolerance the home has separate crockery and cooking equipment to prepare foods, such as a separate toaster and bread maker. All equipment is washed separately. When preparing meals staff stated they are creative at making the meal look as similar as possible to the other meal served. Staff have asked for recipes from family members to ensure that cultural preferences are catered for. To ensure the person has access to similar experiences and to enjoy eating out, an arrangement had been agreed at a local pub, that a prepared meal will be taken and the restaurant has agreed to heat the food and serve alongside the ordered meals. 11 Highfields Road DS0000071129.V363071.R01.S.doc Version 5.2 Page 17 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 a visit to this service. People are able to access healthcare services, and are encouraged to have regular appointments and visit local health care services. People have support to manage medicines and staff have received training to do this safely. EVIDENCE: Plans of care record health care needs and how people are to be supported. One person has epilepsy and a record of any seizures is maintained in conjunction with a sleep chart, as the sleeping pattern helps to identify incidence and frequency of nighttime seizures. Each person is registered with a local General Practitioner and a nurse visits the home from the associated School to monitor any health care issues, and review the Medication Administration Record Sheets. The School Nurse also supports staff with training to understand health needs. 11 Highfields Road DS0000071129.V363071.R01.S.doc Version 5.2 Page 18 Plans of care include details of all appointments and reviews with health care professionals and details of outcomes of any intervention or meeting. The acting manager recorded within the AQAA that ‘the Daily Life Therapy approach encourages exercise, as this has a direct impact upon the behaviour, arousal levels and sleeping and eating habits, which show a marked improvement’. Discussion with staff and family members revealed that all persons are committed to working under the principles of Daily Life Therapy as it has resulted in an improvement in the quality of life of people in the home. One family member reported, ‘I fought hard for my son to come and stay here, as it is in his best interests to continue this therapy, it really does help’. Specialist health care plans record information about the personal support people required to manage identified behaviour. Information includes triggers to the behaviour, how to respond or de-escalate any behaviour and a record of any incident. All incidents are reviewed with the plan on a three weekly basis. Observations of practices demonstrate that staff support people in a manner to which they are comfortable. Discussion with staff revealed that they have an in-depth knowledge of how to support each individual, including personal space, communication and interaction. Staff were seen to be sensitive to individual’s needs. The home has an efficient medication policy, which staff understand, and follow, only the senior person on duty is responsible for administering any medication. Medication records are fully completed, contain required entries, and are signed by staff. The School Nurse from the Horizon School, part of the Priory group, provides support and guidance to staff and completes any Medication Administration Record. A sample audit was conducted, and it was difficult to ascertain the exact amounts of medication that should be in the home. It is recommended that the system be reviewed to ensure there is a balance and an audit trail of medicines. 11 Highfields Road DS0000071129.V363071.R01.S.doc Version 5.2 Page 19 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 a visit to this service. There is a complaints procedure that is clearly written and is available with picture symbols and everyone living at the home has a copy The staff understand the procedures for Safeguarding Adults and have a good knowledge of how to respond to an alert to protect people. EVIDENCE: The Complaints procedure is written with the support of pictorial symbols and a copy is available in the Service User Guide. The form also includes the names of the person’s Key worker, who they may prefer to make aware of any concerns. The acting manager reported that an advocate could be provided for people. There have been no complaints received by us, since the home opened in December 2007. A record of complaints received since opening, has been recorded in a complaints books, along with a separate record of any investigation and the outcome. The complaints received have focused upon trees around the perimeter of the property, which the acting manager reported is being addressed. 11 Highfields Road DS0000071129.V363071.R01.S.doc Version 5.2 Page 20 The induction for staff includes safeguarding adults and the acting manager reported that this training is on going for all persons working in the home. Discussion with staff revealed that people are aware of how to respond to an alert and how to ensure people are safeguarded. 11 Highfields Road DS0000071129.V363071.R01.S.doc Version 5.2 Page 21 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, 25, 26, 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are encouraged to see the home as their own. The home is a very pleasant, safe place to live and the bedrooms are personalised to reflect individual interests. EVIDENCE: Highfields is a modern home, accessed by double iron gates. There is a similar property within the enclosed grounds, owned by the company. The acting manager reported that the second home is to provide a related service, later within the year. The home is an ordinary domestic house and is able to accommodate three people. On the ground floor there is a large lounge area leading to a dining 11 Highfields Road DS0000071129.V363071.R01.S.doc Version 5.2 Page 22 room, which also contains activity equipment and musical instruments. There are patio doors into the garden, which are secure. The acting manager reported that there are plans to landscape the garden and provide outdoor activities; at present it is fully grassed with established trees and plants. The kitchen is fitted to a good standard and there is a dining area, which is used when people prepare food, and eat together at meal times. There is a single toilet for use by all people. On the first floor there are three bedrooms, one of which is en-suite. There is a bathroom with a separate shower cubicle. All bedrooms have been personalised by individuals to reflect their interests. There is an office on the first floor and a separate double garage, part of which has been converted to a utility area. The acting manager reported that the washing machine has a sluice facility. 11 Highfields Road DS0000071129.V363071.R01.S.doc Version 5.2 Page 23 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 a visit to this service. The home has a good recruitment procedure to protect people living in the home. Staff receive a thorough induction to the home and on-going training to enable them to support people who use the service. EVIDENCE: On the day of the visit the staffing in the home consisted of the acting manager working across the shift from 7.00am – 4.00pm. The first shift consisted of: 1 senior personal assistant from 7.00am – 4.00pm 1 personal assistant from 7.00am – 4.00pm 1 vocational personal assistant from 9.00am – 5.00pm The late shift consisted of: 1 senior personal assistant from 3.30pm –10.30pm 1 personal assistant from 3.30pm – 10.30pm 11 Highfields Road DS0000071129.V363071.R01.S.doc Version 5.2 Page 24 There were two Night personal assistants from 10.15pm – 7.15am. The acting manager confirmed that this is the usual pattern of shifts; staff from within the home cover any additional shifts to ensure continuity of care. Where a specific activity has been planned, additional staffing are provided in line with any assessment of risk. Staff files are kept at the Horizon school, part of the Priory Group, a number of staff have worked at the school and moved over to the home to support people and provide continuity of care. The acting manager reported that secure cabinets are being provided and all records will be maintained in the home as required. Three staff records were identified and these were delivered promptly to the home for inspection. We examined the files, which demonstrated that the organisation has robust recruitment practices. All records included a photograph, an application form, two written references, a Protection of Vulnerable Adults (PoVA first) check and a Criminal Records Bureau Check (CRB). Discussion with staff and inspection of records revealed that people received a comprehensive training and an induction over a two-week period. The induction includes the principles of Daily Life Therapy, Observations in home, Foundations for growth, Values, Autism, Epilepsy, Personal Care and Behaviour Management, Health and Safety and Food hygiene. Following the induction staff work under supervision for 2 weeks. The acting manager recorded within the AQAA that the service providers ‘Foundation for Growth computer based staff training ensured that training is current and was up to date, and there was a variety of additional specialist training available to benefit people who used the service’. We examined the records and discussed the training opportunities with staff and discovered that specialist training is identified dependant upon the person’s role, and all core training is repeated annually or six monthly. The training is completed electronically and an assessment carried out after each completed module. Each person has a separate password to log onto the network and given a date they need to complete any training by; the acting manager has access to the whole system and is aware if this is not completed. The on line training is governed by Priory Group. Discussion with relatives of people who use the service revealed that staff communicate well with members of the family. People are supported to communicate on the Internet, by letter and on the phone. Comments regarding the home and staff included, ‘It’s good that staff from the school have come to the home, they know the staff and work well together’, ‘the staff always let us know what’s happening, they’re very good.’ 11 Highfields Road DS0000071129.V363071.R01.S.doc Version 5.2 Page 25 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 a visit to this service. The acting manager has a clear understanding of the principles and focus of the service and manages the home to support people’s individuals’ needs. EVIDENCE: 11 Highfields Road DS0000071129.V363071.R01.S.doc Version 5.2 Page 26 The registered manager is on long term absence from the home. The Acting Manager has completed a Criminal records Bureau Check with us and is in the process of completing an application to submit to begin our Fit Person process with the aim of becoming the new registered manager. It is evident from observation and discussion with staff, that the acting manager is extremely enthusiastic and committed to promoting people’s rights and providing a quality service. The acting manager discussed at length the plans to continue to improve the service and develop the new service, including the major variation to open the adjacent property for three people. The acting manager reported within the AQAA that ‘we are open to developments and suggestions from whatever source they come from. We have a desire to improve and provide best quality care for all residents’. Within the staff meetings, staff have discussed care provision and are seeking to make improvements in consultation with people, their family and professionals. Staff reported this has to be at a pace to suit people using the service. The acting manager is person-centred in her approach and is open and transparent in all areas of managing the home. Staff commented they feel valued and part of a supportive team and would have no hesitation approaching the acting manager. Prior to the Inspection the acting manager completed an Annual Quality Assurance Audit (AQAA) for us. The AQAA contained clear, relevant information that was supported by a wide range of evidence. The AQAA identified the changes they have made since opening, and where they still need to make improvements. Evidence within the AQAA was sampled and found to be accurate. All environmental work and testing was completed as part of the registration process and checked by us prior to the registration the home. This will be reviewed on the next visit to ensure the property is suitable maintained. 11 Highfields Road DS0000071129.V363071.R01.S.doc Version 5.2 Page 27 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 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 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 3 X X 3 X 11 Highfields Road DS0000071129.V363071.R01.S.doc Version 5.2 Page 28 Are there any outstanding requirements from the last inspection? NA STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA20 Good Practice Recommendations To maintain a balance of all medicines to support a full audit 11 Highfields Road DS0000071129.V363071.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection West Midlands West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway Birmingham, B1 2DT 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 11 Highfields Road DS0000071129.V363071.R01.S.doc Version 5.2 Page 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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