Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 23/10/08 for 140 Gloucester Road

Also see our care home review for 140 Gloucester Road for more information

This inspection was carried out on 23rd October 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

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

Information is available to people who use the service, the format of some of the information is user friendly. People who use the service said, "It is very nice living here." "I like living at Gloucester Road." "It was good because I got in with friends." "It is a nice place." Relatives said, "the staff at Gloucester road are very caring and kind." Support plans are detailed and reflect the assessed needs of the people who live at the service. We observed good interactions between staff and people who use the service, and any difficulties that arose during our visit were sensitively and professionally managed. People who use the service felt that staff usually listened to them and acted upon any concerns they raise. One person said, "If I have a problem I tell the staff about it." We saw that the service has a good complaints procedure in place and staff have been trained to recognise and report suspected abuse. Our evidence shows that they have dealt with events that have occured since the last key inspection visit properly. There is some evidence that the service promotes peoples rights to independence and choice. The health and personal care needs of people are being met, there is evidence that the service works co-operatively with health professionals and that people using the service are supported to attend health appointments. We saw evidence that people who have additional health needs such as mobility difficulties are usually provided with the aids and equipment they need. The environment is well maintained, clean and free from offensive odours, infection control procedures are effective The manager is trained and qualified to manage a residential care home. Staffing levels are adequate, but should be kept under review.

What has improved since the last inspection?

The service has maintained high standards of cleanliness despite the difficulties in recruiting to the vacant domestic positions. Staff continue to provide a good standard of service for the people living at the home and promote their rights to independence.

What the care home could do better:

The information available to people who use the service should be up to date and discussed with them regularly and the Service user Guide should contain the fees for the service and any additional costs.People who use the service should have copies of their own support plans and PCP information if they wish to do so and there should be better evidence of how people are involved in care plan evaluations. While the service has made efforts to improve risk assessment, they recognise that there is further work to be undertaken in this area. Although the service has developed small group living areas, there is further work needed to promote levels of independence for the people currently living at the home. The medication storage facility must be improved to ensure that medication is safely stored and records of medication stock should be accurately maintained. Further efforts should be made to promote independence in relation to self administration of medication. And in one example the directions for the administration of medication should be clear and agreed with the person prescribing it. At the last key inspection visit we said that the home also needed to make sure that people who use the service had agreed for the staff to give them their medication. This continues to be recommended. More staff should be trained to National Vocational Qualification (NVQ) level 2 and the recruitment files should be better organised. The organisation should make further efforts to provide sufficient catering and ancillary staff to ensure that support staff are not distracted from their roles. Quality assurance and planning to continually improve the quality of service should be better implemented and the organisation must ensure that monthly visits to the home to assess its performance, are carried out and the reports of these visits are made available for staff and people who use the service to access.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 140 Gloucester Road 140 Gloucester Road Kidsgrove Stoke on Trent Staffordshire ST7 1EL     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Wendy Jones     Date: 2 3 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 30 Information about the care home Name of care home: Address: 140 Gloucester Road 140 Gloucester Road Kidsgrove Stoke on Trent Staffordshire ST7 1EL 01782782596 01782775918 linda.foden@staffordshire.gov.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Staffordshire County Council, Social Care and Health Directorate Name of registered manager (if applicable) Linda Ann Foden Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia learning disability mental disorder, excluding learning disability or dementia physical disability Additional conditions: Date of last inspection Brief description of the care home 140 Gloucester Road is a service providing 24 hour care for 17 people with a learning disability. A number of people who use the service have additional needs including physical, sensory, challenging behaviour and mental health. The home is owned by Staffordshire County Council, managed by the Social Care and Health Directorate and is located in Kidsgrove. It is set back from the road in large grassed grounds. There are two houses in the grounds for people supported through domiciliary services. The Care Homes for Adults (18-65 years) Page 4 of 30 care home 17 Over 65 2 6 0 0 2 17 2 4 Brief description of the care home service does not provide care to these houses, but does retain responsibility for maintenance and health and safety. The service provides all single bedroom accommodation of which eight are downstairs none have en-suite facilities. There is one large communal lounge and an industrial kitchen and three lounges with kitchens. The people who use the service are divided into small groups and the groups spend time in their own lounge and eat together in their kitchen/diners. The majority of people attend Kidsgrove day services. Care Homes for Adults (18-65 years) Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This was a key inspection site visit of this service undertaken on 23 October 2008 and took approximately 05:30 hours. The purpose of this visit was to assess the services performance and to establish if it provides positive outcomes for the people who live there. The visit included checking that any requirements and recommendations of the previous inspection visit of 23 October 2006 have been acted upon, looking at information the service provides for prospective users of the service, their carers and any professionals, looking at information that the service provides to people who use the service to ensure that they understand the terms and conditions under which they have agreed to live at the home and the fees they should pay. Care Homes for Adults (18-65 years) Page 6 of 30 Since the last key inspection visit we have completed an annual service review (ASR). We do an annual service review when there has been no major inspection of the service (we call this a key inspection) in the last 12 months. It does not involve a visit to the service but is a summary of new information given to us, or collected by us, since the last key inspection or annual service review. Other information checked during this visit includes assessments and care records, health and medication records, activity and records relating to the menus, finances, staff training and recruitment, complaints and compliments, fire safety and health and safety checks. The person in charge, staff and people who use the service were spoken to during the site visit and a brief tour of the building was undertaken. Before the visit began, the service provided its own assessment of its performance, in the form of an Annual Quality Assurance Assessment AQAA. Surveys were sent out to people living in the service, relatives, staff and any professional that has involvement in the service. We received five surveys from people who use the service, four from relatives, and one health professional survey. The main points are included in this report. The quality rating for this service is 2 star, This means the people who use this service experience good quality outcomes. What the care home does well: What has improved since the last inspection? What they could do better: The information available to people who use the service should be up to date and discussed with them regularly and the Service user Guide should contain the fees for the service and any additional costs. Care Homes for Adults (18-65 years) Page 8 of 30 People who use the service should have copies of their own support plans and PCP information if they wish to do so and there should be better evidence of how people are involved in care plan evaluations. While the service has made efforts to improve risk assessment, they recognise that there is further work to be undertaken in this area. Although the service has developed small group living areas, there is further work needed to promote levels of independence for the people currently living at the home. The medication storage facility must be improved to ensure that medication is safely stored and records of medication stock should be accurately maintained. Further efforts should be made to promote independence in relation to self administration of medication. And in one example the directions for the administration of medication should be clear and agreed with the person prescribing it. At the last key inspection visit we said that the home also needed to make sure that people who use the service had agreed for the staff to give them their medication. This continues to be recommended. More staff should be trained to National Vocational Qualification (NVQ) level 2 and the recruitment files should be better organised. The organisation should make further efforts to provide sufficient catering and ancillary staff to ensure that support staff are not distracted from their roles. Quality assurance and planning to continually improve the quality of service should be better implemented and the organisation must ensure that monthly visits to the home to assess its performance, are carried out and the reports of these visits are made available for staff and people who use the service to access. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 30 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service can be confident that their needs will be assessed prior to moving in to the home and can be sure that they will receive information about the service this enables them to make an informed decision. Evidence: The service told us in the AQAA that, In October 2007 detailed assessments were completed by managers to reflect needs and choices followed by assessment meetings with designated social workers, family, day services and involvement of advocates. The homes admission procedures ensure that people who may use the service are only admitted following an assessment and have opportunities to visit the home prior to making a decision to move in. The staff are able to meet the needs of the people who use the service and involve other professionals when aisstance is needed. There have been no recent admissions to the service. The service has a Statement of Purpose that provides information about its aims, Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: facilities and resources, but this is currently being updated. We have been told that some people have a copy of the service user guide, which provides additional information and should include the fees and costs of the service. But only one of the people using the service knew what the guide is. People who use the service said, It is very nice living here. I like living at Gloucester Road. It was good because I got in with friends. It is a nice place. Care Homes for Adults (18-65 years) Page 12 of 30 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service can be certain that their care needs are known, recorded and are subject to regular review. They have opportunities to discuss issues affecting their lives and know who their key worker is. Evidence: The service told us in the AQAA that, We have positive relationships with families and supporters of people who use the service. Relatives told us that, I can find no fault with the service my relative receives. We looked at a sample of records and saw that everyone has detailed information about their needs, and that plans are in place to inform staff how people should be supported. The format used by the service is user friendly and follows person centered prinicples, this means that the individual is involved with setting their own aims and goals. We saw that evaluations of care are carried out regularly but could not be sure that all of the people who use the service have been directly involved with these. Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: People who use the service said, Staff talk to me about plans. A member of staff said that one person writes in her own records, this is a good example of person centered thinking. There is very good information about each persons preferred daily routine in the form of a 24 hour plan, in one example this hasnt been completed properly. We looked at a sample of Person Centered Plans (PCP) and saw that they varied in the quality of information some areas didnt appear to have been updated for some time although there is evidence that action plans have been evaluated monthly. The service should ensure that information in records is up to date, this ensures that people who use the service can be confident that staff are delivering appropriate care. Risk assessments are in place for key areas, but there is further work necessary to ensure these are regularly reviewed. We saw that flat meetings are organised to talk about food choices and activities. We looked at the records of these meeting. We are told that the service is looking into ways that they can include people more in the day to day running of the home. Care Homes for Adults (18-65 years) Page 14 of 30 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service have opportunities to access the local community with support, but further effort needs to be made to promote independent living skills. Evidence: The service told us in the AQAA that, We provide opportunities for social activities either independently or supported by staff, Day Services opportunities, supporting relationships with sexual awareness training for people who use the service and staff. We spoke to 8 people living at the home all commented that they are very happy with their life at Gloucester Road. They talked to us about their plans for the future and the proposal to close Gloucester Road. A number of people stated that they hoped to be able to move into accommodation that is a more domestic style than Gloucester Road. Two people said they hoped to have a bungalow where they can be supported and be Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: able to choose who provides their support. Most people living at Gloucester Road go to day services and college. Two people currently have limited structured activities out of the home but this is due to specific difficulties and health problems. The service is working with behavioural management services to develop plans to support one person and working with health professionals to support the person who is unwell. We saw that although people are engaged in some activities and people said that they are happy, there is a need for further and proper integration into the community. As the bulk of the activities they are engaged in is with their peers in specialist services. During this visit we saw three people preparing to go to the theatre, additional staff came in on duty to take them. One person told us, I go shopping with my brother sometimes. We looked at menus and saw there is a choice of meal at each meal time, people who use the service said, we dont cook for ourselves, the meals are cooked in the kitchen. Id like to be able to cook for myself. We spoke to one person who is wheelchair dependent and were told, I cant wash the dishes because I cant reach the sink, but staff bring the washed dishes to me at the table and I dry them. We have been told that the service has three couples living at the home, we spoke to them and confirmed that they are supported by the service,with any guidance they need around personal relationships and intimacy. Care Homes for Adults (18-65 years) Page 16 of 30 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service can be confident that the service will support them to access appropriate health care, but must be sure that medication is managed safely to ensure people are not at risk. Evidence: The service has told us in the AQAA that it supports people who use the service to access a range of health services. All are registered with a General Practitioner. We saw records that show people have regular health checks such as dental, eye care and chiropody. A number of people wear hearing aids and are referred to audiology when necessary. Some people have additional health needs, the service has demonstrated that they work in co-operation with health professionals and are currently working with behavioural and psychiatric service to develop strategies for two people. One health professional returned a survey and said, Staff have always ensured that the District Nursing Team are aware of any changes in our patients condition and are eager to learn. Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: We discussed the needs of one person who presents behaviour that challenges the service and have been told that management strategies are in the process of being agreed with the comuunity nursing team to determine the best method of supporting the individual and reducing the behaviour. We saw that the current medication store is not big enough to accommodate all of the medication that is delivered to the service safely. Staff said that the service has changed its medication supplier recently and now uses a Monitored Dosage System (MDS). We said that appropriate medication storage facilities must be provided and since we carried out our visit we have been told that new storage facilites have been provided. We looked at a sample of Medication Administration Records (MAR) and noted good standards of record keeping, we discussed the need to be able to account for medication from the point of delivery, there was just one example where the stock control records are not accurately maintained. We saw that one person has been precribed Chlorpromazine when needed, but we could not see a protocol in place that gives staff clear guidance about when this medication should be given. This potentially place the individual at risk. Since this visit we have been told that a protocol has been put in place. Finally, at the last at the key inspection visit we recommended that the service should record that people who use the service have agreed that the service can administer their medication and we would also recommended that further work is carried out to promote self-medication. Care Homes for Adults (18-65 years) Page 18 of 30 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service can be sure that the service has policies and procedures in place for making complaints and to safeguard them against the risk of abuse. Evidence: The service told us in the AQAA that, they have a complaints policy and procedure in place. Relatives have told us that know how to make a complaint, one person said, I can find no fault with the care my brother receives. People who use the service say, Id talk to my key worker if I have any problems. Staff make sure that everything is okay and I dont have any concerns. Ive told staff about my broken drawers and bed base but nobody has done anything about it. We alerted staff to this and they agreed to ensure that repairs or replacements are made. We saw other areas of good practice including grumbles books in the flats, although when we looked at them couldnt be sure that people who use the service are actively encouraged to use them as some entries are quite old. Since the last key inspection visit we have been informed of two safeguarding referrals at the home. There have been a number of incidents of property theft. The service has followed procedure and reported the incidents to the Police and local authority and has acted to reimburse affected people. There have also been changes in the home to minimise the risk of this type of incident happening again. Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: We have been told that staff have received training in recognising and reporting abuse. Care Homes for Adults (18-65 years) Page 20 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service can be sure that the service is clean and provides sufficient communal and personal space to meet their needs. But need to be confident that repairs to furniture are dealt with promptly, as delays potentially place them at risk. Evidence: The service told us in the AQAA that, We maintain high standard of cleanliness providing a homely, comfortable, safe environment. People who use the service said, I have my room how I want it and have all my things, another said, we can help with the dishes but I cant reach the sink, so dry dishes at the table, another said, my chest of drawers are broken and the drawer under my bed is jammed stuck, Ive told staff about it. Relatives said, The environment could be updated. We recommend that the organisation looks at how it can make further adaptations to the environment to meet the diverse needs of the people living at the home. We saw that the service is clean and well maintained. The style of the home does not reflect an ordinary domestic dwelling but efforts have been made to create four smaller living areas comprising of a lounge/dining room and each with its own Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: kitchenette. It is recommended that further efforts are made to promote peoples independence in this area. We saw that there are very few provisions stored in the fridges or cupboards, we also noted that in flat 2 the fridge thermometer registered at 20c, and that the records of fridge temperatures are not up to date, this potentially places people who use the service at risk. We told staff about this for their immediate attention. We saw a sample of bedrooms and note that they are well personalised, have lockable facilities and people who use the service can lock their bedroom doors if they want to. Bathing and toilet facilities are provided in sufficient numbers to meet the needs of the people who live in the home and have adaptations for those with a physical disability. Care Homes for Adults (18-65 years) Page 22 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff receive the support they require to deliver care, but they are often used to cook and clean which takes them away from their supporting role and although the people using the service like the staff team, they cannot be confident that they are all trained to support them. Evidence: The service told us in the AQAA that, We have retained a consistent staff team. Support staffing levels appeared to be satisfactory but should be kept under review as they have also taken responsibility for some domestic tasks due to difficulties with recruitment. The rota for the day of the visit shows; 2 support staff between 8am-3pm 1 support staff between 10am-4pm 1 support staff between 3pm-10pm 1 support staff between 4pm-10pm 2 waking nights staff between 10pm-08am. These levels appeared to be comparable with other days and we saw that additional staff are bought in to support people who use the service to access the community. We saw that staff meetings are arranged regularly, the last is dated 04 September 2008, staff sign to say they have read minutes, the records show a good level of Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: discussion. At the last key inspection visit we recommended that the number of trained staff is improved, we are told that due to some transfer of staff to the home from other services this has been improved, but note that in the AQAA the records show that only 7 of the 22 support staff has trained to National Vocational Qualification(NVQ) level 2, lower than the recommended minimum of 50 of the care team. We saw that there are some gaps in the records of staff training but also noted that updates are planned. We are told that staff receive regular 1:1 supervision sessions. We looked at the recruitment records of two staff who have been transferred from other services. We saw that recruitment practice is of a good standard but recommended that the records are streamlined for ease of access. Relatives said, the staff at Gloucester Road are very caring and kind I think the day service is very good for teaching the residents new skills. People who use the service said, I know who my key worker is. I like the staff they talk to me and help me do things. Care Homes for Adults (18-65 years) Page 24 of 30 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service can be certain the the manager of the service has the experience and skills necessary, but need to be sure that records are up to date and that the service is continually improving. Evidence: The service provided us with the AQAA when we asked for it, but we noted that it provided limited information about the service it provides. It does tell us that equipment in the home has been serviced regularly and the policies and procedures have been reviewed. The manager of the service is registered with us and approved as a fit person to manage the service. We have been told that since the last key inspection visit her management team has been improved with no current vacancies. Relatives said in their surveys, The manager at Gloucester Road keeps the people who live there safe and happy and all seem to get on well together. Care Homes for Adults (18-65 years) Page 25 of 30 Evidence: We looked at some records to be sure that fire drills are taking place regularly and other safety checks are being carried out. We saw that some risk assessments need to be reviewed, the manager has said in the AQAA that this is an area that needs to be improved. We looked at records and saw that fire training is up to date, fire risk assessments have been carried out and people who use the service told us they know what to do in the event of a fire. We have been told that the organisation has not audited the home on a monthly basis as expected. We saw the report of the most recent visit is dated 03 April 2008. The organisation should recommence monthly visits to the service and make the reports of the outcome of these visits available to staff and the people who live in the home. Ideally they should also be produced in a user friendly format. We have been told that the service monitors the quality of the service it provides and includes collecting the view of other stakeholders such as relatives and professionals who have involvement in the home. The service should produce an annual development plan for the service based upon the outcome in the feedback they receive. The service keeps us informed of any accidents and incidents in the home. We have found that the service promotes a person centred approach and understands what it needs to do to ensure that people who use the service are fully involved in decision making and setting thier future goals. Care Homes for Adults (18-65 years) Page 26 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 27 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 13 The current storage facilities 23/01/2009 for medication should be changed to comply with current guidance. This ensures that people who use the service can be confident that medication is managed safely. 2 32 18 The provider must take action to recruit to the vacant domestic and catering positions. To ensure that support staff are not distracted from their supporting role. 23/01/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 1 The Service user guide and Statement of Purpose should be produced in user friendly format to ensure that people;e who use the service are able to understand the information it contains and should have access to them. Page 28 of 30 Care Homes for Adults (18-65 years) 2 1 The service should ensure that the Service User Guide and Statement of Purpose is updated and included the fee range. The service should ensure that risk assessments are regularly reviewed. The service should ensure that people who live there are involved in care planning and reviews. The service should give further thought to how people who use the service can become more independent. The service should continue to explore further access to community based activities that are valued and integrated. Protocols for the administration of as required medication should be in place. The service should provide facilities and adaptations to ensure that the diverse needs of the people who use the service can be met. The flats should be developed further to their full potential and to support people who use the service to further develop their independence. The service should ensure that broken furniture is mended or replaced in a timely manager this ensures that people who sue the service can be confident that the service values them and is committed to providing a quality service. The provider should ensure that domestic fridges are maintained at an ambient temperature as recommended by environmental agencies. The service should ensure that at least 50 of staff have the opportunity to train to NVQ level 2. The provider should produce an annual development plan based upon the quality audits it undertake and the views of the people who live at and have an interest in the service. The provider should ensure that monthly visits to the service are carried out and report from these visits are available in the home and in a form that people who use the service can understand. This ensures that people who sue the service can be confident that the services performance is being monitored. The service should ensure that risk assessments are reviewed regularly. 3 4 5 6 7 8 6 6 12 12 20 24 9 24 10 24 11 30 12 13 32 39 14 39 15 42 Care Homes for Adults (18-65 years) Page 29 of 30 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 30 of 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. 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!