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Inspection on 13/09/07 for 429 Warwick Road

Also see our care home review for 429 Warwick Road for more information

This inspection was carried out on 13th September 2007.

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

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

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home provides good information for people so that they are clear about what they can expect from the home. The service user guide and complaints procedures are in an illustrated, easy ready format to help people to understand the information more easily. Good care plans are in place, containing information to enable staff to support people in the correct way so that their needs are met properly. Care reviews take place with the involvement of relatives and professionals to check that people`s needs are being met properly. In a questionnaire a reviewing officer from Solihull Social Services speaks highly of the service;"429 Warwick Rd is a person centred service that always respects clients wishes and choices and encourage achievable goals". People are supported to gain access to the community on a regular basis and to enjoy a good range of activities. The home recognises and organise Birthday celebrations. A big party was arranged for a person celebrating her 40th Birthday with the involvement of her family and friends. The people at the home are supported to gain access to health professionals to monitor their health needs and promote good health, e.g. annual dentist, opticians and well person checks. Suitable procedures are in place for managing complaints and staff are trained to recognise and report any suspicions of abuse so that people are protected from harm. People spoke very positively about the staff that support them and indicated they are very happy at the home. People feel listened to and regular meetings take place so that people can have their say, make plans, agree activities and review menus. Questionnaires are sent to people`s relatives to seek their views of how the home is running so that any improvements may be considered. Maintenance contracts are in place for gas, electrical and fire equipment to ensure that the home is safe for people to live and work in.

What has improved since the last inspection?

A development plan has been written for the home and has been actioned during the year, including improvements to two bedrooms and the development of a sensory garden, based on the wishes of people at the home. The manager carries out checks to ensure the home is safe to live in and a senior manager also visits to ensure that everything is running well. Records are being kept of the food people eat so that their dietary needs can be monitored properly. Inventories of people`s personal furniture and equipment have been updated and where more expensive items have been purchased by people this has been agreed with relatives, who have signed their consent. The rota has been changed to include a member of staff on duty throughout the weekdays so that people are able to return home from their day services if they wish to do so.

What the care home could do better:

People have been issued with contracts recently. The contracts have been signed b y relatives to show that people have had their interests representedbut the contracts have not yet been dated. The manager agreed to arrange for the contacts to be dated promptly. The manager agreed to update a person`s epilepsy risk assessment, to reflect agreements about reduced levels of support at bath time. Overall the home is well maintained and kept in good condition for people but improvements are necessary to some carpets and the settee in the lounge. Overall staff are well trained in Health and Safety related practices as well as National Vocational Qualifications and other care courses. There is a recommendation for staff to receive training in sexuality and personal relationships, as well as equality and diversity. These courses help to equip staff to respond sensitively to people`s individuality and their personal needs.

CARE HOME ADULTS 18-65 Warwick Road, 429 Solihull Birmingham West Midlands B91 1BD Lead Inspector Kevin Ward Key Unannounced Inspection 13th September 2007 07:30 Warwick Road, 429 DS0000004512.V350784.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 Warwick Road, 429 DS0000004512.V350784.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. Warwick Road, 429 DS0000004512.V350784.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Warwick Road, 429 Address Solihull Birmingham West Midlands B91 1BD 0121 704 4563 F/P 0121 704 4563 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) Milbury Mrs Sue Kiely Care Home 7 Category(ies) of Learning disability (7) registration, with number of places Warwick Road, 429 DS0000004512.V350784.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 5th September 2006 Brief Description of the Service: 429 Warwick Road is registered to provide accommodation and care for a maximum of 7 adults with learning difficulties. The home is situated on a main road with its own small car park at the front of building. The home is a large attractive modern building in keeping with the design of other houses in the neighbourhood. Bedrooms are situated on both the ground floor level and the upper floor of the home. Whilst the dimensions of the hallways and the staircase to the first floor make the house unsuitable for wheelchair users, the bedrooms on the ground floor levels provide a suitable living situation for some service users with minor / moderate mobility related needs. The home provides care to male and female service users , primarily in the middle age range. During the week service users are encouraged to make use of Day Service provision although service users often spend sometime at home. The home is situated within reasonable distance of shops and local amenities and the service has its own vehicle to support residents to access the community. The CSCI inspection report is available in the home for visitors to read if they wish to. The manager said that current fees start at £975.00 per week. People are required to pay personal items and extras, such as clothing and pay a £5.00 per week contribution to the cost transport. Warwick Road, 429 DS0000004512.V350784.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key unannounced inspection which addresses all essential aspects of operating a care home. This type of inspection seeks to establish evidence showing continued safety and positive outcomes for residents’. The inspection focused on assessing the main key Standards. As part of the inspection process the inspector reviewed information about the home that is held on file by us, such as notifications of accidents, allegations and incidents. 6 people at the home returned questionnaires. Three of the people had difficulty answering the questions, due to their communication needs. Three questionnaires provided helpful views of life at the home. A reviewing officer from Solihull Social Services Department also completed a questionnaire. The inspection included seeing the six people that live at the home. Two people were particularly chatty and provided the inspector with some helpful insights about life in the home. The inspection also included case tracking the needs of two people that live at the home. This involves looking at people’s care plan and health records and checking how their needs are met in practice. Discussions took place with a member of staff, on duty at the home, as well as the manager. A number of records, such as care plans, complaints records, and fire safety records were also sampled for information as part of this inspection. An annual quality assurance assessment was completed and returned by the provider in time for this inspection, providing the manager’s views of the home’s performance during the last year. What the service does well: The home provides good information for people so that they are clear about what they can expect from the home. The service user guide and complaints procedures are in an illustrated, easy ready format to help people to understand the information more easily. Good care plans are in place, containing information to enable staff to support people in the correct way so that their needs are met properly. Care reviews take place with the involvement of relatives and professionals to check that people’s needs are being met properly. In a questionnaire a reviewing officer from Solihull Social Services speaks highly of the service;“429 Warwick Rd is a person centred service that always respects clients wishes and choices and encourage achievable goals”. Warwick Road, 429 DS0000004512.V350784.R01.S.doc Version 5.2 Page 6 People are supported to gain access to the community on a regular basis and to enjoy a good range of activities. The home recognises and organise Birthday celebrations. A big party was arranged for a person celebrating her 40th Birthday with the involvement of her family and friends. The people at the home are supported to gain access to health professionals to monitor their health needs and promote good health, e.g. annual dentist, opticians and well person checks. Suitable procedures are in place for managing complaints and staff are trained to recognise and report any suspicions of abuse so that people are protected from harm. People spoke very positively about the staff that support them and indicated they are very happy at the home. People feel listened to and regular meetings take place so that people can have their say, make plans, agree activities and review menus. Questionnaires are sent to people’s relatives to seek their views of how the home is running so that any improvements may be considered. Maintenance contracts are in place for gas, electrical and fire equipment to ensure that the home is safe for people to live and work in. What has improved since the last inspection? What they could do better: People have been issued with contracts recently. The contracts have been signed b y relatives to show that people have had their interests represented Warwick Road, 429 DS0000004512.V350784.R01.S.doc Version 5.2 Page 7 but the contracts have not yet been dated. The manager agreed to arrange for the contacts to be dated promptly. The manager agreed to update a person’s epilepsy risk assessment, to reflect agreements about reduced levels of support at bath time. Overall the home is well maintained and kept in good condition for people but improvements are necessary to some carpets and the settee in the lounge. Overall staff are well trained in Health and Safety related practices as well as National Vocational Qualifications and other care courses. There is a recommendation for staff to receive training in sexuality and personal relationships, as well as equality and diversity. These courses help to equip staff to respond sensitively to people’s individuality and their personal needs. 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. Warwick Road, 429 DS0000004512.V350784.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Warwick Road, 429 DS0000004512.V350784.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2 and 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides people with good levels of information and support so that they can make an informed decision to move to the home. EVIDENCE: A copy of the Home’s Statement of Purpose is available in the hallway of the home along with other helpful information, such as the complaints procedure. People have also been provided with copies of the service user guide. This contains a helpful insight into what people can expect from the home and is an easy read format with photographs and illustration to make it easier for people to understand. Letters were seen on people’s files as evidence that their relatives are informed when we carry out an inspection, so that they may request a copy of the report. No new people have moved into the home since the last inspection. The home has a satisfactory admission procedure in place for new people. In the annual quality assurance assessment, completed by the manager, she explains that people are subject to a full assessment and provided with opportunities to visit the home before moving in. The assessment procedure also includes a commitment to involving people in planning their move to the home and in reviewing the success of the placement. Warwick Road, 429 DS0000004512.V350784.R01.S.doc Version 5.2 Page 10 Contacts are in place containing the terms and conditions and fees so that people know their entitlements. Two contracts were checked; relatives had signed both but neither had been dated. The manager said that she would address this promptly. Warwick Road, 429 DS0000004512.V350784.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Overall people’s needs are planned for and reviewed so that they receive the support and assistance they require to go about their daily lives. People are involved in decisions that affect them so that they can exercise greater control and independence over their daily lives. EVIDENCE: Three people’s care plans were checked. The care plans contain good levels of helpful information and advice to enable staff to provide sensitive support to people. They also contain helpful information about people’s preferred routines at different times of the day, including morning and nighttime routines. This information is particularly beneficial for people with high communication needs, who are not able to readily express their choices, in order that their preferences can be respected by staff and their needs met in the way they like. Warwick Road, 429 DS0000004512.V350784.R01.S.doc Version 5.2 Page 12 Care review notes demonstrate that people’s needs are being routinely reviewed with the involvement of their relatives and social workers. Notes of “network meetings”, held to review people’s progress at day services, were also seen on file. The notes show that staff from the home are represented at these meetings, along with relatives, to assess that the day services activities are still meeting people’s needs. Recent positive action has taken place to support a person to find an alternative day service placement, as it was believed the crowded day service was a source of stress for the person concerned. The manager explained that consideration is being given, by social workers, to developing a joint reviewing system whereby day service and residential care reviews are carried out at the same time. It is hoped this will save duplication of everyone’s time. Positive work has taken place to make the care plans easier for people to read making very good use of photographs and illustrations. A satisfactory range of risk assessments were seen for people addressing general hazards (e.g. kitchen safety, and road safety) as well as risks specifically associated with their personal needs, such as epilepsy. Guidelines were seen for a person who has occasional outbursts. The guidelines have been devised with a psychologist and provide staff with practical advice for sensitively supporting the person concerned. A complaint was made to us that a person with epilepsy is not properly supervised at bath times. The manager said that the person concerned has had no reported seizures witnessed or reported for 15 years and that the psychiatrist is questioning this diagnoses. Consequently the level of supervision has been relaxed to be proportionate to the risk presented and the need for some privacy. The health notes verify that health professionals are involved monitoring this person’s epilepsy needs. The manager undertook to review the risk assessment promptly to take account of the reduced need for supervision when bathing, to ensure that risk assessment guidelines correspond to current care practices. People confirmed that they are encouraged to make decisions and choices about matters that affect their everyday lives. As well as being involved in the day service meetings and care reviews they are involved in interviewing staff and have regular meetings to discuss issues in the home. The notes of meetings show that these forums are used to keep people informed, e.g. managerial changes in the organization as well as for discussing everyday living issues such as menus and activities. Good work has continued to involve service users in the development of a sensory garden. A person at the home spoke enthusiastically about this development and of the enjoyment derived from the garden. Two people confirmed that they had recently been involved in choosing the colour schemes and new furniture for their bedrooms and had been supported to shop to choose curtains. Warwick Road, 429 DS0000004512.V350784.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,15,16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are supported to take part in a good range of community leisure activities and are involved in menu planning so that they are provided with a good social life and with meals they enjoy. EVIDENCE: The people at the home attend day services during the week. The manager explained that there is now always a member of staff on duty during the day so that people can stay at home if they need to, e.g. if they are sick. This was also verified by two people at the home and by a member of staff. One person explained that they enjoyed his gardening job and swimming and another spoke said they enjoyed working on a farm and horse riding. Comments by people at the home and entries in activities records demonstrate that the home supports people to gain regular access to the community. Evaluation records are completed by staff to report on the extent to which Warwick Road, 429 DS0000004512.V350784.R01.S.doc Version 5.2 Page 14 people have enjoyed the planned activities so that adjustments can be made to people’s activities plans where necessary. Examples of activities include pub trips, meals, cinema, musician, ball games, parks, shopping and day trips. One person said that he particularly enjoys having a drink at the pub and another said that he had been to the cinema at the weekend to see a new film release. The activities recorded in people’s care plans were observed to correspond with activities that are actually arranged for them. Photographs were seen of a person’s 40th Birthday party that had been arranged by the home. The person’s friends and relatives were invited to the party, which took place in a function room. The manager explained plans to put the photographs in an album for the person concerned. People at the home explained that they regularly go to a disco each week to meet with friends from other services. Entries in people’s day notes and review records demonstrate that they are supported to maintain regular contact with their relatives and to receive representation at care review meetings. The manager confirmed that none of the staff have had recent access to sexuality and personal relationships training. This training is helpful so that staff are better equipped to give sensitive advice and support to people where necessary. Encouragement is provided for service users to take part in many aspects of daily living, such as cleaning and tidying, shopping for personal items and carrying their personal laundry baskets to the laundry room. People have lockable furniture in their bedrooms to keep their personal belongings safe. No restrictive practices are evident in the home. People were seen to move through the home and garden freely in a relaxed fashion. People spoken with commented that they liked the food provided and confirmed that choice was available. The menus and the records of food eaten indicate that people are provided with a varied, balanced diet. People confirmed that they take part in reviewing the menus and shopping for groceries. Evidence of involvement in menu planning was also seen in the notes of residents’ meetings. The menus are available in a picture format, making them easier to understand for service users. A menu board in the dining area also displays pictures of the meals for that day. The manager indicates that has previously attended a nutrition course. The manager said that staff aim to shop for healthy options such as low fat yoghurts and cakes fruit and “light sugar, evidence of which was seen in the kitchen. Records of food eaten now include the contents of people’s packed lunches. Comments by people at the home confirmed that they enjoy the packed lunches provided by the home. Weight records are being kept to help staff to monitor any weight variations, which might indicate any health issues or the need for dietary changes. The manager said that people at risk of choking on their food are never left unsupervised when eating their meals. Risk assessments are in place for people to minimize this hazard. A member of staff was seen to be present in Warwick Road, 429 DS0000004512.V350784.R01.S.doc Version 5.2 Page 15 the kitchen throughout the time that a person with such needs was finishing their breakfast. Warwick Road, 429 DS0000004512.V350784.R01.S.doc Version 5.2 Page 16 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 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People receive the care and support they require form staff and healthcare professionals in order that their personal care and health care needs are met properly. EVIDENCE: Comments by people confirmed that they like the staff at the home and feel safe in their company. The people at the home looked very comfortable and at ease with the manager and the member of staff on duty. Everyone was dressed in age appropriate, modern, well-laundered clothing. All were clean and well groomed, indicating that they are valued and encouraged to maintain a good self-image. A member of staff on duty was able to demonstrate a good awareness of people’s needs and the support they require, which corresponded to the information in their care plans. People preferences with regard to gender care are recorded in their care plan. The manager reports that one male member of staff has recently left but another is due to start shortly, which will help to maintain a degree of male involvement for people at the home. Warwick Road, 429 DS0000004512.V350784.R01.S.doc Version 5.2 Page 17 A sample inspection of health records indicates that people are receiving routine access to general health services, such as well person’s checks, dentist, eye tests, flu vaccinations and chiropodist. Evidence of regular weight monitoring was observed on people’s files. Where necessary people are being referred to health professionals for advice and treatment. The home has made use of input from other health professionals in the development of guidance and to monitor people’s care, e.g. psychologist has been used to develop behaviour management guidelines and the consultant psychiatrist is reviewing a person’s medication for epilepsy. Health action plans are in place for people containing details of people’s health needs and the arrangements to address these needs. The action plans have been devised with a lot of picture symbols with the aim of making the information easier to understand. The manager said that she intends to review these documents again and add more photographs and less symbols, as currently the information is obscured because there are too many symbols, which is distracting. The home uses a monitored dose system for medication. Records that medication had been received, administered and where appropriate returned are being appropriately kept. The home retains copies of prescriptions so that staff can check the correct medication has been received from the chemist and a countdown record is being kept of home remedies, such as paracetamol. This enables the home to account for all the tablets correctly. Protocols are in place for home remedies, explaining the reasons that the medication may be given and any side effects that could occur. The training matrix shows that staff have received medication training. The manager carries out assessments of staff to check their understanding of safe medication practices. Boots pharmacy booklets were seen on staff files, which include a competency check that staff complete as part of medication training, to demonstrate they have understood the training. Warwick Road, 429 DS0000004512.V350784.R01.S.doc Version 5.2 Page 18 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Suitable procedures are in place for managing complaints and staff are trained to recognise abuse so that people are protected from harm. EVIDENCE: Since the last inspection there has been one complaint to us about the home concerning unsafe care practices. The complaints were investigated by the provider and not upheld. There have been two complaints directly to the home by neighbours, regarding occasional noise levels in the garden and the height of the hedge. Comments by the manager and entries in the complaints log indicate that these issues have been managed effectively and appropriate action has been taken to resolve the neighbours concerns. Since the last inspection one person made a complaint about a member of staff shouting at them. This manager reported this matter to us and informed Social Services. The member of staff involved no longer works the home. People have been provided with access to an illustrated version of the complaints procedure; a copy is in the information pack in the hallway. Two people at the home said they would see the manager or their keyworker in the event that they had any concerns. A member of staff confirmed that she had been provided with adult protection training had seen the adult protection and whistleblowing procedure. These Warwick Road, 429 DS0000004512.V350784.R01.S.doc Version 5.2 Page 19 procedures are necessary so that staff know how to raise any suspicions of abuse or report concerns about the running of the home. Two people’s expenditure records were checked. The records show that personal expenditure is being properly logged and receipts are being kept. The records are routinely checked and signed by the manager to confirm that people’s money is being correctly accounted for. Warwick Road, 429 DS0000004512.V350784.R01.S.doc Version 5.2 Page 20 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The accommodation continues to be well maintained and improved so that people live in a comfortable, homely environment that meet’s their needs. EVIDENCE: Overall 429 Warwick Rd is an attractive home, providing accommodation on a large domestic, scale in a comfortable modern environment. The rear of the home has been extended to provide an attractive dining area overlooking the garden. This provides a comfortable room that benefits from good natural sunlight, in which people can dine or relax. During the last year, good work has taken place to freshen up the décor in the communal areas of the home, including the lounge, kitchen, hallway, stairs and landing. Two more bedrooms have also been redecorated in line with their colour choices and people have been supported to shop for matching bedding, curtains and other items. Warwick Road, 429 DS0000004512.V350784.R01.S.doc Version 5.2 Page 21 People’s bedrooms are decorated, furnished and equipped, in keeping with their preferences and personalities. One person has had a mural painted on the walls by an artist, and the ceiling has been painted with pictures that reflect in a special light at nighttime. The home has a walk in shower, downstairs and a domestic style bathroom upstairs. The grouting and in the downstairs shower room is discoloured and needs cleaning or re-grouting. The settee in the lounge has been stained and the covers are split over one of the arms. The carpet has a burn mark and needs to be replaced. The carpet in the hallway is also looks grubby and would benefit from replacement. The garden is well maintained and staff have worked well with the people at the home to develop an attractive sensory garden with birdbaths, ornaments and lights. A cleaning rota is in place to support cleaning in the home. Overall the home was clean with no unpleasant odours. There is not currently a need for staff to manage any significant amount of continence laundry. A member of staff was seen to make use of protective clothing and gloves, stocks of which are conveniently placed in different areas of the home. A member of staff confirmed that she had received infection control trading. Staff training information provided by the manager demonstrates that the majority of the staff have had this training. The laundry room is situated well away from the laundry room so there is no risk of infection due to laundry being carried through food proportion areas. People have separate laundry baskets and are encouraged to carry them to the laundry room to encourage their independence. Similarly people confirmed that they are involved in cleaning and tidying their bedrooms with support and encouragement from staff, where necessary. Warwick Road, 429 DS0000004512.V350784.R01.S.doc Version 5.2 Page 22 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34 and 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff are properly recruited, vetted and trained so that people benefit from a suitable staff team, equipped to meet their needs. EVIDENCE: The majority of staff have worked together for several years, helping to provide consistency of care at the home. The rota shows that there are always two or three staff on duty. The manager said that since the last inspection the rota has been adjusted to include the provision of a member of staff during the weekdays so that people can return from day services if they wish to do so, e.g. due to sickness. This was verified by an examination of recent rotas. A sample examination of two staff training files and certificates and information on the manager’s staff training matrix was reviewed. This indicates that staff are provided with access to a good range of training in Health and Safety related subjects, such as fire safety, moving and handling and food hygiene in addition to care courses, such as epilepsy, autism and person centred planning. Warwick Road, 429 DS0000004512.V350784.R01.S.doc Version 5.2 Page 23 In the annual quality assurance assessment, completed by the manager as part of this inspection, she reports that 50 of permanent staff hold National Vocational Qualifications (NVQ’s) at level 2 or above. One member of staff also holds a nursing qualification. The manager said that more staff would be undertaking NVQ training. Staff are also provided with access to learning disability award framework training as part of the induction process. The manager reports that staff have not recently been provided with training related to sexuality and personal relationships or equality and diversity. The files of the two staff recently recruited to the team were examined. Both files contained evidence to demonstrate that people are properly recruited and vetted before starting at the home, e.g. application forms, references and Criminal Record Bureau (CRB) checks. Comments by a member of staff and the manager confirmed that staff are provided with access to regular planned supervision, as well as daily access to the manager or the two assistant managers. Supervision records also verified that planned supervision is provided. Warwick Road, 429 DS0000004512.V350784.R01.S.doc Version 5.2 Page 24 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Suitable arrangements are in place for consulting with the people at the home and other interested parties so that the home is managed in a manner that takes account of the views of the people that live there. EVIDENCE: The manager has been in post for four years and has 25 years experience of working with people with learning disabilities. The manager also holds the Registered Managers Award and the National Vocational Qualifications level 4 in care. As such she is suitably qualified and experienced for her role. There are also two assistant managers to cover the home in the absence of the manager. Warwick Road, 429 DS0000004512.V350784.R01.S.doc Version 5.2 Page 25 Checks are routinely carried out by the manager and a senior manager to ensure that the home is running well. The manager frequently checks people’s monies and signs to verify that the balance is correct. Routine environmental checks are also carried out covering such matters as cleaning, electrical, risk assessments, food safety transport and water temperatures. Reports were seen verifying that a senior manager carries out regular monitoring visits at the home each month, which includes speaking to staff and the people that live there. A member of staff confirmed that team meetings take place for staff. A sample examination of the meeting records indicates that these forums are used purposefully, to share policy information and discuss people’s care. As previously noted meetings are held for the people that live at the home so that they can contribute to everyday living plans. The manager explained that questionnaires have recently been sent to relatives and day service staff to seek their views of the home. The manager said that these views would be used to inform this year’s development plan. A copy of the current development plan shows that people’s views have been considered, e.g. the development of a sensory garden and decorating and equipping bedrooms have been carried out as planned. A newsletter has been devised by the home, which features developments and events that have taken place during the year and which is sent to people’s relatives to keep them updated. Three people at the home have recently taken part in interviews for new staff so that they can have a say in who works with them. In the annual quality assurance assessment the manager reports that the essential Health and Safety maintenance checks have been carried out. The fire safety log was sampled. This demonstrates that alarms and lights are being properly tested and maintained and fire drills are being carried out at the home. Certificates were seen, demonstrating that suitable maintenances contracts are in place for gas and electrical equipment. Fridge and freezer temperature records show that these appliances are working efficiently. Hot water temperature monitoring records indicate that the water is maintained at a safe temperature. Warwick Road, 429 DS0000004512.V350784.R01.S.doc Version 5.2 Page 26 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 x 4 x 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 x 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 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 Version 5.2 Page 27 Warwick Road, 429 DS0000004512.V350784.R01.S.doc 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. 1 2 3 4 Refer to Standard YA5 YA9 YA24 YA35 Good Practice Recommendations Arrange for new contracts to be dated so that it is clear when they have been signed. Proceed promptly with plans to modify the risk assessment of a person with epilepsy, to take account of the reduced requirement for close supervision. Plans should be made to replace the torn settee and the carpet in the lounge (with iron burn mark) and the carpet in the hallway, which looks dirty. Staff should be provided with training in sexuality and personal relationships and equality and diversity. These courses heighten awareness of people’s individuality and equip staff to respond sensitively to people’s personal issues. Warwick Road, 429 DS0000004512.V350784.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Birmingham Office 1st Floor Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ 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 Warwick Road, 429 DS0000004512.V350784.R01.S.doc Version 5.2 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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