Inspection on 04/07/07 for 14 Podsmead Road

This inspection was carried out on 4th July 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 found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Similar services:

32 Beaumont Way

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

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

CARE HOME ADULTS 18-65 14 Podsmead Road 14 Podsmead Road Gloucester Glos GL1 5PA Lead Inspector Mrs Kate Silvey Unannounced Inspection 4th July 2007 2:30pm 14 Podsmead Road DS0000068626.V339059.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 14 Podsmead Road DS0000068626.V339059.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. 14 Podsmead Road DS0000068626.V339059.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 14 Podsmead Road Address 14 Podsmead Road Gloucester Glos GL1 5PA 01452 314262 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) Mr D Solanki Mrs Deborah Fiona Weston Care Home 5 Category(ies) of Learning disability (5), Learning disability over registration, with number 65 years of age (5) of places 14 Podsmead Road DS0000068626.V339059.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 21/06/06 Brief Description of the Service: The home can accommodate up to five adults who have a learning disability. The home is an adapted house and situated in Podsmead, which is approximately two miles from Gloucester city centre. The service users accommodation is on three floors and comprises of a lounge, dining area and kitchen. The bedrooms are single and there is a bathroom and toilet on the ground and first floors. There is a garden at the back of the property and this has been developed and now provides a pleasant and accessible area for the service users. In the garden there is an aviary, a fishpond, a patio area and level lawns. 14 Podsmead Road DS0000068626.V339059.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The judgements contained in this report have been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. The inspection was unannounced completed over 4.5 hours with one inspector. Five people are accommodated in the home and all were seen, and spoken to by the inspector. The inspector spoke to the manager and a carer just going off duty. The registered manager had sent a completed Annual Quality Assurance Assessment to the Commission and four people who live in the home had completed surveys, some with the help of a carer. A number of records were viewed including care plans and medication records. The care and records of three people who live in the home were looked at in detail. The environment was inspected during the day, and the manager was observed talking to the people who live there. Fees range from £430 – £630 per week and are reviewed by the Community Adult Care Directorate (Social Services) should care needs change. There are additional charges for, some chiropody/podiatry hairdressing, newspapers and magazines. What the service does well: The manager ensures that people who are making a choice about where they live are well assessed and have the right information. Social and healthcare professionals, family and advocates are included in the assessments and people can visit and meet the staff several times to find out about the home. The home only admits people after all the procedures are complete and everyone is satisfied that individual needs can be met. The people in the home enjoy lots of activities, which include; snooker, the cinema, the theatre (recently seen an ABBA tribute band), evening clubs, college (Adult Supported Learning), horse riding, bowling, going shopping, meals out, Karaoke, colouring, artwork, jigsaw puzzles and sewing. People also enjoy going on holidays with the staff. The people seen at the home were calm but actively enjoying the things they like to do. The staff respect people’s privacy and help them to keep in contact with family and friends. People are well supported by the staff and their personal preferences are known and respected. Health and social care professionals, for example the dentist and optician help look after people in the home and their advice is recorded and taken. A healthcare professional survey returned to the 14 Podsmead Road DS0000068626.V339059.R01.S.doc Version 5.2 Page 6 Commission stated that ‘the manager is very proactive at seeking advice, always acts on it and records as necessary. She is also very good at passing information to family and other services’ Tablets are handled safely by well trained staff and where possible people are helped to take their own medicines. The home is well looked after and the rooms are bright and comfortable with many personal pictures and ornaments. The home is clean and there are no unpleasant smells. People are proud of their home and were relaxed and comfortable during the inspection. The home has a low staff turnover and has experienced staff that can talk and listen to people with ease to find out what they need, and look after them well. The manager is qualified and experienced and wants the people who live in the home to have the best possible care and support. Procedures and policies are regularly reviewed and equipment is well maintained to help ensure safe practices in the home. The manager says fees are based on the Gloucestershire County Council ‘ Fair Pricing Tool’ and that everything is looked at to ensure that all areas are considered and cost are based on looking at what people need. What has improved since the last inspection? What they could do better: 14 Podsmead Road DS0000068626.V339059.R01.S.doc Version 5.2 Page 7 The manager recognises that communication with day centres could be better to ensure people’s safety and welfare. A more secure and efficient way of finding out the information from day services is recommended while they are used. The staff are planning to improve peoples skills with regard to using transport, shopping for food and helping with the cooking. Some minor improvements should be made to the home to ensure all people are safe. The areas requiring attention are; the toilet handle, the unrestricted window, and the utility room walls. The manager plans to provide more supervision and training for staff to ensure they can meet the changing needs of people, which includes dementia care. New staff must have all records completed before they start work in the home to ensure people are well cared for and safe. A review of staffing levels should be completed to avoid the manager completing excess care duties and having little time to complete records. 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. 14 Podsmead Road DS0000068626.V339059.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 14 Podsmead Road DS0000068626.V339059.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): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The needs and wishes of people planning to live in the home are well assessed, and the information available for them to make a choice is in a form that is easy for them to understand. This helps to ensure that they will have appropriate facilities to lead a full active life and can continue lifelong learning. EVIDENCE: The manager explained that before an admission to the home information is provided by the social worker. The manager also completes an assessment and a good example was seen which included information from the family, existing carers and the Community Learning Disability Team. People visit the home several times before they move in to meet the staff, and appropriate methods of communication are used, for example Makaton (symbols). The Service User Guide is produced in a pictorial and symbol form to help people understanding the information, which includes the complaints procedure. The manager makes a point of explaining the complaints procedure to all families involved. 14 Podsmead Road DS0000068626.V339059.R01.S.doc Version 5.2 Page 10 The four surveys returned to the Commission said that the people there had enough information about the home and had chosen to live there. The inspector spoke to everyone and they all said they liked living in the home. The Statement of Purpose seen required updating with the new providers details and the inspector was told that the correct copy was on the computer ready for printing. The manager is exploring ways of informing more people about the home, and the home has recently been included in a new regional database for homes providing care for people with a learning disability. The views of visiting professional have been sought to ensure the home can provide appropriate facilities for people making a choice about where they live. There is also a proposal to provide more choice for people by providing ground floor accommodation. 14 Podsmead Road DS0000068626.V339059.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 & 9 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The care actions were detailed and recorded well, they contained the information required to help staff meet individual needs. The daily records and the monthly reviews were meaningful. People were asked about their preferences and included in the monthly reviews. Risk assessments were completed to enable people to achieve daily tasks safely and promote independence. EVIDENCE: Three care records looked at in detail contained very detailed individual actions to support each person to meet their daily needs. Goals to work towards had also been identified. The information included personal preferences relating to all aspects of their life for example: • how people liked to be washed • what food people liked and how it should be served 14 Podsmead Road DS0000068626.V339059.R01.S.doc Version 5.2 Page 12 what support was needed for continence care how people needed to be helped with mobility problems including out and about in the community. • what things they liked to do for enjoyment and contact with friend and relatives. • care from professionals such as dentist, doctors and opticians • how people’s finances are recorded and the help needed to organise them. Risk assessment’s were recorded where they were needed, for example; when people had help taking their own medication, making hot drinks and opening locked doors. The monthly review of the care records were meaningful and assessed the progress made and were discussed with the people each time. The daily records seen were an excellent example of describing how people were and what happened to them. People attending day centres had a book that staff could write in to say what happened, but information was minimal as should the book go missing anyone could read it. The manager felt that communication with the day centres could be improved, but these services will soon be reduced and the home will be providing more activities in the future. The homes new keyworker policy has helped care staff to provide a more individual approach to people in the home as each person has a carer who makes sure their needs are met. A survey returned from a healthcare professional stated that the home managed people’s needs very well and supports them to live the life they choose. All the surveys from people living in the home said they make decisions about what they do each day, and one person liked making plans for activities at the weekend. The manager stated that the views of people in the home will be sought when providing the new activities, and when any changes to the rooms in the home are made. • • 14 Podsmead Road DS0000068626.V339059.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): 12, 13, 15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a varied lifestyle for people in the home, which includes activities in the community. Relationships are maintained with family and friends and people are respected. Privacy and dignity are maintained and people were seen relaxing and engaged with staff in their daily activities. Meals are planned and menus seen were balanced, varied and provided choice. People liked the food provided. EVIDENCE: Apart from attending day centres where varied activities take place the people in the home have their own leisure pursuits that they enjoy. These include; snooker, the cinema, the theatre (recently seen an ABBA tribute band), evening clubs, college (Adult Supported Learning), horse riding, bowling, going shopping, meals out, Karaoke, colouring, artwork, jigsaw puzzles and sewing. 14 Podsmead Road DS0000068626.V339059.R01.S.doc Version 5.2 Page 14 One person is learning about road sense to try and improve their independence. Another person works at a furniture recycling workshop and is completing an NVQ in furniture restoration. Each person has a pictorial plan on the notice board of what they do at the day centre, which included a picture of their keyworker at the centre. The person who attends college has a pictorial timetable and enjoyed showing the inspector all her work. The work was a high standard, and although this person cannot read or write and has some difficulty with speech the enthusiasm seen was a good indication of the success of the placement. One person showed the inspector pictures of their horse riding and was extremely proud of her achievements One person returned from the day centre and was spoken to while she was enjoying colouring in a picture book and another person told the inspector about the music at the day centre. The atmosphere in the home was calm but active with everyone doing what they wanted to do, which included watching a film on the television. Two people had been out for lunch to a local pub with a carer on the day of the inspection. They said they enjoyed their meal and often went out for lunch. The staff rota had been arranged to ensure that one person could have a day at home each week to provide one to one care, as attending the day centre was becoming stressful. There has also been increased staff for activities in the community to allow two staff to accompany four people. A holiday for everyone was planned for later in the month. The manager also has plans to improve people’s independence with regard to using transport and recognises the importance of maintaining contact with family and friends and building personal relationships. Evidence of this was seen in the daily records, and the home has a policy on sexuality and relationships. People open their own mail and are enabled to vote in elections when they wish to. The manager has provided journals for staff to read which identifies the best practices in recognising individual needs and providing choice for people with a learning disability. The privacy and dignity of people are respected and staff were heard asking if bedrooms could be entered. People are called by the name they choose which is sometimes different from their correct name but preferences are recorded. The people spoken to said that they liked the food provided in the home and the manager said their preferences are recorded. The dining room is a pleasant area where staff and people living in the home enjoy eating together. Time was taken over the evening meal and the manager said it is a good way of talking together at the end of the day. 14 Podsmead Road DS0000068626.V339059.R01.S.doc Version 5.2 Page 15 A copy of the menu sent to the Commission indicated that a balanced and varied diet was provided. A variety of packed lunches are made each day during the week and there is a choice of evening meal. There is a specific care plan recorded for everyone’s dietary needs and their weight is regularly recorded. There are also plans to help people become more independent with food shopping and preparation of meals. 14 Podsmead Road DS0000068626.V339059.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, & 20 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. The people are well supported in their daily living as preferences are known and respected. There is a good relationship with staff and people look calm and active while feeling safe in their home. All healthcare needs are well met through support from professionals and their advice is recorded and used to benefit the people in the home. Medication is well managed and staff have accredited training to help ensure safe handling of medication to protect people in the home. EVIDENCE: People are supported well with their individual preferences and the home is very much a family home as three people have lived there for about ten years and one for three years. The experienced registered manager does most of the care in the afternoon/evenings and sleep-in night duties and has known the people since they moved into the home. There appears to be a good caring but enabling relationship with staff where people feel safe in their home and look relaxed. 14 Podsmead Road DS0000068626.V339059.R01.S.doc Version 5.2 Page 17 There is flexibility regarding mealtimes, bathing and getting up and going to bed. The healthcare records seen were detailed and the manager had started completing some on the computer, which was not easy for all staff to access. Letters were seen from healthcare professionals that included the Speech and Language Therapist, the occupational therapist and a Care Programme Approach plan from the psychiatrist. A recent assessment for one person had involved the process of assessing ‘dementia pathways’ as their needs were changing. The manager is planning that all people with Downs Syndrome over 35 years of age are assessed in line with new guidelines from the NHS. The home has recently recruited a carer with experience in the care of people with dementia. The manager has had a lot of help from health and social care professionals in the past year increasing the staff’s access to services and knowledge. This has helped staff to respond well to peoples changing needs and to plan staff training. Continence care is managed well with the support of the continence adviser. A healthcare professional survey returned to the Commission stated that ‘the manager is very proactive at seeking advice, always acts on it and records as necessary. She is also very good at passing information to family and other services’ Three people take medication and one person is helped to self medicate from a monitored dosage system. The administration records were complete and the manager is planning to record a monthly audit. It was recommended that any ‘as required’ medication should have a recorded protocol. The staff know the people well and the manager stated they are able to manage the medications. There are no homely remedies used in the home. All staff have had accredited medication training from the local college and the manager supervises to ensure competence. There is a good medication procedure that was recently updated by the manager during her Registered Managers Award training. It is recommended that the home obtain a copy of the guidance from The Royal Pharmaceutical Society. The home had a new British National Formulary for medication reference. The medication was safely stored and staff keep the key with them at all times. 14 Podsmead Road DS0000068626.V339059.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 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staff have a good relationship with people in the home which helps ensure they can share any worries with them and that they feel safe. The people are well protected from abuse as staff have had the correct training and there are procedures for them to follow. Peoples personal monies are kept safe and they are helped to understand how this is done. EVIDENCE: The complaints procedure has been shown to all people living in the home and any family or supporters, and staff help ensure they understand it as far as possible. The home has a policy and procedure for handling complaints in the home and no complaints have been recorded. Concerns people have are dealt with daily, and the staff have tried to ensure that people feel safe to make comments about any worries they may have. Daily records support this as they are detailed and well written. The manager plans to complete policies and procedures in a format that is more easily understood by everyone in the home, for example using symbols. All staff have regularly completed Protection of Vulnerable Adults training and the homes has procedures for staff to follow. 14 Podsmead Road DS0000068626.V339059.R01.S.doc Version 5.2 Page 19 Finances are handled for the service users and good records are kept. It is recommended that two staff audit the records regularly to protect everyone in the home. The people living in the home are helped to understand how their money is handled by taking them to withdraw the money and helping them to choose how they spend it. 14 Podsmead Road DS0000068626.V339059.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 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well maintained, safe and clean; however, some minor improvements could be made to ensure all people are safe. People are proud of their home, it is clean and free from unpleasant odours. There is good access to the local amenities which people enjoy using. The gardens provide a safe and interesting area for people to relax in. EVIDENCE: All communal rooms and bedrooms in the home were seen as comfortable, bright and attractive with many personal pictures and ornaments. There was one empty room and the provider is considering an alternative use to a lounge/office on the ground floor. The people were proud of their bedrooms and their home and enjoyed showing them to the inspector. One bedroom has an unrestricted window that required a risk assessment to safeguard everyone in the home. Fire records were complete and the manager 14 Podsmead Road DS0000068626.V339059.R01.S.doc Version 5.2 Page 21 had completed a fire risk assessment in September 2006 and stated that this is reviewed annually. The manager was aware that the handle on a toilet required repair, this should be completed to help ensure people can be independent. The utility area could be improved by ensuring the brick walls were easy to clean as they were not painted. The manager has been completing risk assessments for all areas of the home since the environmental health officers last visit. The gardens were well maintained and had interesting features for people to see with the aviary and the fishpond. The manager is planning to buy new garden furniture. There is good access to the local amenities which people in the home enjoy using. All areas of the home were very clean and there were no offensive odours. People in the home complete some simple cleaning but mainly the home is cleaned by the staff. The registered manager has enrolled to complete training related to infection control. 14 Podsmead Road DS0000068626.V339059.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 & 35 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The staff are experienced and know the people well which helps them to support them. Staff have training to ensure people are safe and protected and the manager plans to improve the training to meet the changing needs of people. Recruitment records seen were incomplete and must be more robust to help ensure the safety of everyone. EVIDENCE: The home has gradually increased the staff team during the last year and there are two new staff members. There are four care staff, one full-time and three part-time, 50 permanent staff and 100 of bank staff have completed NVQ level 2 training or above. The registered manager is a Registered General Nurse and a Registered Nurse (Mental Health). There is a low staff turnover and staff have completed a relevant induction programme. All staff have completed training in safe food handling and have maintained a programme of 14 Podsmead Road DS0000068626.V339059.R01.S.doc Version 5.2 Page 23 training to include; emergency first aid, fire safety, safe handling of medicines and protection of vulnerable adults. The manager has provided the Commission with detailed information regarding the staff training completed and stated that staff have the relevant skills and considerable experience to care for the people in the home. The manager says that the staff are able to communicate well with the people in the home and understand their individual and changing needs. A new staff member has experience with dementia care and it is recommended that all staff have this training with regard to older people with a learning disability. There are four female and one male carer employed which helps provide some choice when help with personal care is given. Generally there is only one carer on duty, unless the needs of people change, as the people in the home are very settled and staff know them well. Two staff are provided for some activities outside the home. The manager is planning to provide more in-house activities, which may require additional staff. The staff rota was provided by the manager who sometimes works more than sixty hours each week, not including sleep-in duties. This appears to be a considerable amount of time, which may leave little time to complete records, review procedures and help professionals with assessments. It is noted that there has been an increase in staff, however, regular reviews should be completed to help ensure that the manager has time to supervise staff and meet with them regularly. Recruitment records were seen for the last two people employed, and Criminal Records Bureau checks for two staff not seen by CSCI before. Recruitment records were incomplete for one person employed in a care home with nursing elsewhere, as the provider and manager had not realised that CRB checks were no longer portable. This was discussed with the manager who agreed to complete a CRB as soon as possible. The carer would not be on the rota until the CRB was completed and had only occasionally worked for the home, and was not on the four-week rota provided. All staff complete an application form but induction records were not complete and the inspector provided the manager with information regarding new Skills for Care induction standards. 14 Podsmead Road DS0000068626.V339059.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 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well run by a qualified and experienced manager who wants the people who live in the home to have the best possible care and support. Procedures and policies are regularly reviewed and equipment is well maintained to help ensure safe practices in the home. Quality assurance methods could be improved but efforts are made to find out what people think about the care provided. EVIDENCE: The registered manager is well qualified having completed the Registered Manager Award and is a Registered General Nurse and a Registered Nurse (Mental Health). 14 Podsmead Road DS0000068626.V339059.R01.S.doc Version 5.2 Page 25 She has run the home for many years as the provider and now has the sole role of registered manager. The inspector met the new provider during the inspection as he was helping to support the manager with catering requirements on the day. The manager stated that the change in provider had run smoothly and did not affected the people in the home. The manager understands the need to ensure a safe home for people and information provide to the Commission in the Annual Quality Assurance Assessment indicates that the home has the relevant policies in place and has recently reviewed most of them. The maintenance of equipment is complete which helps to ensure people are safe. The manager seeks the views of people who visit the home to help assess the quality of care but finds it difficult using traditional methods such as surveys as people do not understand them. It is recommended that all verbal views received are recorded so that information can be looked at later and acted upon. The new provider will be able to help the manager improve quality assurance methods to focus on improvements in caring for people. Information in the AQAA also includes the homes continued commitment to equality and diversity. The manager recently completed a study of Hinduism whilst completing the RMA and hopes to build on this information and produce specific records for prospective people who may wish to live in the home. The manager says accommodation fees are based on the Gloucestershire County Council ‘ Fair Pricing Tool’ and that everything is looked at to ensure that all areas are considered and cost are based on looking at what people need. 14 Podsmead Road DS0000068626.V339059.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 X 2 3 3 X 4 X 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 2 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 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 4 4 3 x 3 X 3 X X 3 x 14 Podsmead Road DS0000068626.V339059.R01.S.doc Version 5.2 Page 27 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. 1 Standard YA34 Regulation 19 Sch(2) Requirement The registered person must ensure that all staff have a CRB and POVA list check before commencing employment. Timescale for action 15/08/07 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 5 Refer to Standard YA20 YA23 YA24 YA24 YA35 Good Practice Recommendations The registered person should ensure that any ‘as required’ medication should have a protocol for staff to follow. The registered person should ensure that personal monies are regularly audited with two people. The registered person should ensure that a risk assessment is completed for an unrestricted window to ensure everyone is safe. The registered person should ensure that the utility room walls can be easily cleaned. The registered person should ensure that staff have dementia care training to help meet the changing needs of people. 14 Podsmead Road DS0000068626.V339059.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Gloucester Office Unit 1210 Lansdowne Court Gloucester Business Park Brockworth Gloucester, GL3 4AB 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 14 Podsmead Road DS0000068626.V339059.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. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!