Inspection on 19/09/07 for Warwick Road, 4

This inspection was carried out on 19th 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 found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Warwick Road, 4 20/10/09

Warwick Road, 4 31/07/06

Warwick Road, 4 28/11/05

Warwick Road, 4 20/07/05

Warwick Road, 4 16/02/05

Warwick Road, 4 04/08/04

Similar services:

22 Sandown Road

The Highlands

Dilston College Of Further Education

West View House

Prince Bishop Court

Park View (15)

Craigmore House

1 Lanark Close

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Warwick Road, 4 4 Warwick Road Wallsend Tyne And Wear NE28 6RT Lead Inspector Glynis Gaffney Unannounced Inspection 19 & 24th September 2007 14:30 Warwick Road, 4 DS0000000358.V351105.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, 4 DS0000000358.V351105.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, 4 DS0000000358.V351105.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Warwick Road, 4 Address 4 Warwick Road Wallsend Tyne And Wear NE28 6RT 0191 234 4655 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) Northern Life Care Limited T/A U.B.U. Ms Ruth Wilcox Care Home 4 Category(ies) of Learning disability (2), Learning disability over registration, with number 65 years of age (2) of places Warwick Road, 4 DS0000000358.V351105.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 31st July 2006 Brief Description of the Service: No 4 Warwick Road is a purpose built semi-detached bungalow. The home is registered to provide care for four adults with learning disabilities who may also have physical disabilities. The home does not provide nursing care. It is situated in the centre of Wallsend and is close to all local amenities. There is a pleasant garden to the rear and car park to the side of the building. The current range of charges for a place at the home are £994 to £1174. There are extra charges for hairdressing and private chiropody. Information about fees charged is included in the home’s service user guide. A copy of the most recent inspection report is available in the main reception area. Warwick Road, 4 DS0000000358.V351105.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. We looked at: • • • • • Information we have received since the last visit on 31 July 2006; How the service dealt with any complaints & concerns since the last visit; Any changes to how the home is run; The manager’s view of how well they care for people; The views of relatives and staff. People living at the home were unable to complete surveys. The Visit: An unannounced visit was made on the 19 September 2007. During the visit we: • • • • • • Observed people who live at the home and talked with the manager; Looked at information about the people who use the service & how well their needs are met; Looked at other records which must be kept; Checked that staff had the knowledge, skills & training to meet the needs of the people they care for; Looked around the building to make sure it was clean, safe & comfortable; Checked what improvements had been made since the last visit. We told the manager what we found. What the service does well: This is a sample of what the service does well: Relatives who returned surveys said that: • • ‘The home gives me peace of mind that my relative is being looked after’; ‘On occasions we have seen my Aunt out in her wheelchair around Wallsend. She always looks cosy and comfortable. I understand she is taken to shows and other activities which members of staff say she enjoys.’ Staff who returned surveys said: Warwick Road, 4 DS0000000358.V351105.R01.S.doc Version 5.2 Page 6 • • • ‘I have worked over a year now, the home has turned around very well from me first starting, the service users are happy and well looked after’; ‘The training provided is very good. Any areas we feel (we) need inhouse training (it) gets sorted out for us.’ ‘I am always trained in how I need to work effectively and (am) updated on new ways. I get formal and informal training. There is usually a recap/refresher course for any changes in the way we work’; People living at the home are supported to be as independent as possible living full and stimulating lives. Peoples’ weekly planners, and the activities they engage in, reflect their needs, age, gender, personal interests and preferences. People live in a home that is clean, tidy and nicely furnished. Peoples’ bedrooms reflect their own personalities and preferences. The provider has put arrangements in place to ensure that: • • Staff are competent to do the job for which they are employed; Staff have completed training relevant to working with people with learning disabilities. The provider carries out regular visits to monitor the quality of care and services provided at the home. The tenants have purchased a car, which has made it easier for them to use local facilities and participate in community events. People living at the home are supported to take holidays. For example, one person had just returned from a holiday in Spain. Raised flowerbeds have been provided making it easier for people to participate in garden based activities. In-house training incorporates a unit on ‘Valuing Individuality and Difference’. Team leaders deliver this training. Staff have completed ‘A Getting to Know You’ assessment for each person. All staff complete a confidentiality/data protection form on starting work for the provider. Staff working in, and people using the provider’s services, are encouraged to contribute to the Company’s ‘Inspired by U’ newsletter. Warwick Road, 4 DS0000000358.V351105.R01.S.doc Version 5.2 Page 7 What has improved since the last inspection? What they could do better: Ensure that all staff complete infection control training. Complete the Department of Health ‘Essential Step for Infection Control’ publication. This will help protect people living at the home from poor hygiene and developing infections that may lead to ill health. Replace the flooring in the corridor and dining/lounge areas. This will mean that people are able to benefit from living in a home that is well maintained and meets their needs. Ensure that the manager obtains a nationally recognised qualification in care and management at level 4 or equivalent. This will ensure that the home is managed and run by a person with an appropriate qualification. Ensure that staff update their moving and handling training yearly. This will help ensure that people are moved in a safe manner by staff that have updated their knowledge and skill competencies. Warwick Road, 4 DS0000000358.V351105.R01.S.doc Version 5.2 Page 8 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, 4 DS0000000358.V351105.R01.S.doc Version 5.2 Page 9 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Warwick Road, 4 DS0000000358.V351105.R01.S.doc Version 5.2 Page 10 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Peoples’ needs are fully assessed before they move into the home. This means that staff know about the needs of each person and what care and support they require. EVIDENCE: Peoples’ needs are assessed before they are offered a place at the home. Each person’s care records contain a copy of their social services assessment and care plan as well as the home’s ‘Getting to Know You’ assessment.’ Standard two has not been fully assessed, as there have been no new admissions into the home since the last inspection. The provider has policies and procedures that set out how people can be referred and assessed for a place at the home. Warwick Road, 4 DS0000000358.V351105.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. People have good support plans that clearly set out how their assessed needs are to be met. This will help make sure that peoples’ individual needs and preferences are catered for. Staff will also be clear about how they should care for people. EVIDENCE: Support specifications have been devised for each person setting out what support they require and in what areas. Support specifications cover such areas as medication, managing personal finances, continence, and morning and evening routines. They are detailed, easy to understand, written in plain English and are reviewed on a regular basis. However, none are in a format that can be more easily understood by people living at the home. People are Warwick Road, 4 DS0000000358.V351105.R01.S.doc Version 5.2 Page 12 unable to sign their support specifications to confirm their agreement with the contents. To communicate effectively with the people in their care, staff rely on the experience they have developed in understanding peoples’ needs and wishes through their behaviour, mood and non-verbal language. The speech and language team have supported staff to devise and implement communication programmes and activities that encourage people to develop skills in expressing their own needs and wishes. For example: • • • Staff use a laminated board with photographs of favourite activities and meals to help one individual make simple choices and decisions; Monthly house meetings are held at which issues such as purchasing furniture and holiday plans are discussed. People living at the home attend these meetings; Advocacy support is provided on request and in response to peoples’ assessed needs for support with decision-making. In the surveys returned by staff, all said that they had been given up to date information about the needs of the people they support. One of the two staff on duty had completed communication skills training. Of the two relatives who returned surveys: • • One said that the home ‘always’ met the needs of their relative; The other person said that this only happened ‘sometimes’. A range of risk assessments have been completed for each individual covering such areas as showering, choking and access to the kitchen. The risk assessments provide staff with guidance on how to promote independence whilst also keeping people safe. Warwick Road, 4 DS0000000358.V351105.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 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 provided with a good range of opportunities to join in local activities and to make use of everyday community facilities. This allows them to participate in, and be a real part of, everyday community life. EVIDENCE: Staff support people to join in meaningful daytime activities and use everyday community facilities. For example, one individual has a support specification that involves devising a weekly activities planner. Some of the activities engaged in by the person involve visiting the cinema and going bowling. This person also accesses aromatherapy sessions provided at the home and makes use of a foot spa as part of her activity plan. Another individual is supported to access the kitchen and to attend weekly ‘snack’ lessons. Warwick Road, 4 DS0000000358.V351105.R01.S.doc Version 5.2 Page 14 Records are kept of the activities that people participate in. The home’s rotas are built around peoples’ leisure interests and pursuits and staff are expected to be flexible within their shift pattern. Of the two relatives who returned surveys: • • One person said that the home ‘always’ supported people to live the life they chose; The other person said the home ‘usually’ did this. People are provided with opportunities to develop and maintain important personal and family relationships. Peoples’ care records contain information about family members. Support specifications have been devised to promote peoples’ continuing contact with their families. For example: in one individual’s care record, reference is made to the arrangements for promoting contact with their mother. There is clear written guidance for staff regarding how they should respect and safeguard peoples’ right to privacy. People have opportunities to mix with individuals who do not have disabilities through their contact with the local community. Of the two relatives who returned surveys: • One person said that they ‘always’ receive enough information to help them make decisions about their relative’s well being. This person also said that the nature of her relative’s disabilities made it difficult for staff to help her keep in touch; The other person said that this was ‘usually’ the case. • The home uses a four-week menu cycle. The menus are varied and offer choice. Alternatives to the main meal choices are available. In-line with their support specifications, and in so far as they are able, people are supported to participate in decisions about what types of meals will be included on the menus. For example, in one person’s support specification, there is reference to staff and the dietician working together to devise a four-week menu planner. Each person has a support specification that identifies their need for assistance with eating and drinking. All of the people living at the home require some degree of assistance in this area. Meals are served in a form that enables each person to eat their food safely. The home has sought input from the speech and language therapy team and the dietetic service. Peoples’ care records contain information about their food likes and dislikes. The inspector observed the lunchtime meal. Staff supported people to eat their meals in a kind, patient and considerate manner. The mealtime was unrushed and relaxed. Warwick Road, 4 DS0000000358.V351105.R01.S.doc Version 5.2 Page 15 Of the two relatives who returned surveys: • • One person said that the home ‘always’ supported people to live the life they chose; The other person said the home ‘usually’ did this. Warwick Road, 4 DS0000000358.V351105.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The systems in place to support the safe administration, storage and disposal of medication are satisfactory and promote peoples’ good health. EVIDENCE: People are registered with a local GP practice, optician and dentist. They have regular access to dental, optical, chiropody, and where required, more specialised health care services. Each person has a range of support specifications that promote their health and well being. These cover such areas as support required when having a seizure, attending medical appointments and receiving emergency medication. Charts are used to monitor peoples’ health care needs. For example, in one person’s care record, staff have completed charts that monitor their sleep pattern, continence and skin care needs, fluid intake and susceptibility to bruising. In another person’s care record, there is reference to them receiving support from the speech and language team. A health promotion plan has also been completed for this person. Staff have completed training in specialist health care areas such as Quality This jud this serv Warwick Road, 4 DS0000000358.V351105.R01.S.doc Version 5.2 Page 17 epilepsy, use of emergency medication and speech and language therapy. People using the service are unable to comment on whether their health care needs are well met. Support specifications have been prepared that set out how peoples’ personal care needs should be met. For example, in one person’s care records, there is guidance on how to meet their need for support with bathing, oral hygiene and maintaining their continence. There are records covering the ordering, receipt, administration and disposal of medication. All medicines are kept safely locked away. None of the people living at the home administer their own medication. One staff member’s file contained evidence that they had completed certificated medication training and their competency to administer medication had been assessed. Checks of the air temperature of the room in which medications are stored are carried out daily. The medication cupboard and cabinet are kept in a clean, tidy and hygienic condition. Following the last inspection, creams are now appropriately stored and each person’s medication is written up on their drugs record sheet. Warwick Road, 4 DS0000000358.V351105.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. The written procedures for handling complaints are satisfactory. The relatives of people using the service are confident that their complaints or concerns would be listened to, taken seriously and acted upon. EVIDENCE: The home has a complaints policy and procedure. Each person has a support specification that sets out how staff will support them to make a complaint. Neither the home, nor the Commission, have received any complaints since the last inspection. Two relatives who returned surveys said that the home had made them aware of how to make a complaint. People using the service are unable to comment on how complaints are handled by the home. In the returned staff surveys, three people said that they knew what to do if they received a complaint. One member of staff said that they did not. The home has safeguarding policies and procedures. Since the last inspection, there has been one incident requiring a referral in line with these procedures. This matter has since resolved. Also, three former staff have been referred to the Protection of Vulnerable Adults List in line with the provider’s safeguarding Warwick Road, 4 DS0000000358.V351105.R01.S.doc Version 5.2 Page 19 responsibilities under the Care Standards Act and Care Home Regulations. With one exception, all staff have received training in the protection of vulnerable adults. The person concerned was a recently appointed member of staff. The manager agreed to resolve this matter following the inspection. Warwick Road, 4 DS0000000358.V351105.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, 25, 29 and 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 equipped to meet the needs of the people accommodated. This means that people have access to the equipment and adaptations needed to keep them safe. EVIDENCE: A tour of the premises revealed no hazards. Peoples’ bedrooms are attractively decorated and furnished. There are no shared bedrooms. The communal areas are well maintained attractive areas with the exception of the corridor and dining/lounge room carpets, which are stained and grimy. During the inspection it was confirmed that a new kitchen is shortly due to be fitted which will be better adapted to meet the needs of people living at the home. Warwick Road, 4 DS0000000358.V351105.R01.S.doc Version 5.2 Page 21 Each bedroom is different and reflects the needs and personalities of the occupant. The layout and design of the home enables people to live together in a homely domestic environment. People share a lounge/dining room and kitchen. The home is generally clean, tidy, hygienic and there are no unpleasant odours. One member of staff has not received training in the control of infection. The manager said that this would be resolved following the inspection. The Department of Health infection control good practice checklist has not been completed. The inspector agreed to forward a copy. The home has been adapted to meet the needs of the people living there. A range of specialist aids and equipment have been provided. For example: • • Bathrooms have been fitted with variable height baths, hoisting equipment and grab rails; The home has a mobile hoist, pressure relieving mattresses and visual sensory equipment. Warwick Road, 4 DS0000000358.V351105.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 and 36. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Robust pre-employment checks are carried out on new staff before they start work at the home. This is an important step in ensuring that people who maybe unsuitable to work with vulnerable adults are not employed at No 4 Warwick Road. EVIDENCE: Staff personnel records confirm that: • • • • Staff have undergone Criminal Records Bureau Disclosure checks and received a contract of employment; Two written references have been obtained for each applicant; Each member of staff has completed an application form and provided a full employment history; Verification of identity has been obtained. Warwick Road, 4 DS0000000358.V351105.R01.S.doc Version 5.2 Page 23 However, the inspector was unable to physically check completed application forms and original i.d. documents, as copies are not kept at the home. Following the inspection, the manager agreed to personally check each staff member’s i.d. so that she could fill in the required documentation for inspection purposes. Although the provider forwards a copy of each applicant’s health questionnaire to the home, .the Summary of Staff Information Form held at No 4 Warwick Road does not clearly specify that applicants have provided a written statement confirming their physical and mental health. Neither does the Form specify the reasons why staff have ended their last period of employment where this involved working with vulnerable adults or children. All but one member of staff have obtained a nationally recognised qualification in care at level 2 or above. One person is in the process of completing training to this level. Staff that have completed a care qualification have covered equality and diversity issues as part of this training. Basic equality and diversity awareness is provided during induction training. The home’s manager said that she hoped to provide all staff with more in-depth equality and diversity training during the next 12 months. The home has a rota that sets out the number of staff on each shift. The rota contains the required information with the exception of staff designations. Although a minimum of two staff are always scheduled on duty throughout each 24-hour period, the working rota had not always been updated to reflect this. An examination of one week’s rota showed that the following staffing levels had been provided to meet the needs of the three people living at the home: 78 Mon 2 Tue 2 Wed 2 Thu 2 Fri 2 Sat 2 Sun 2 89 3 2 2 2 2 2 3 910 3/4 2 2 ¾ 2/3 3/2 3 1011 3 2 3 4 2 2 3 1112 3 2 3/2 4 2 2 2 121 3 2 2 4 2 2 2 12 3 2 2 4 2 3 2 23 3 2 2 4 2 3 2 34 3 2 2 3 2 2 2 45 3 2 2 2 2 2 2 56 3/2 2 2 2 2 2 2 67 2 2 2 2 2 2 2 89 2 2 2 2 2 2 2 910 2 2 2 2 2 2 2 1011 2 2 2 2 2 2 2 The manager’s hours are in included in the shift complement. Staff, with input from people living at the home where appropriate, carry out all housekeeping and catering duties. A waking night staff worker and a member of staff who ‘sleeps over’ in the building, cover the nighttime period. Although the manager said that the home’s staffing levels are sufficient to meet the needs of the people living at the home, staff that returned surveys said: Warwick Road, 4 DS0000000358.V351105.R01.S.doc Version 5.2 Page 24 • • • ‘They could make sure the staffing levels don’t stay low for so long which puts less pressure on the staff and makes it a better home for the service users’; ‘(We have) been short staffed for a very long time now’; ‘There (are) usually (enough staff on duty), but sometimes we get short staffed.’ An examination of the rotas showed that: • • Over an eight day period, a member of staff worked 70 waking night hours; A carer worked sixteen hours covering a day shift from 4 pm to 10 pm and then a waking night shift from 10 pm to 8 am. The manager said that the above circumstances had occurred because of unforeseen staff sickness and maternity leave. On the day of the inspection, sufficient numbers of staff had been scheduled on duty and people appeared well cared for. In one staff member’s file, there was evidence that they had completed training in all key statutory areas such as first aid and food hygiene. However, the staff member concerned needed to update their moving and handling training. Arrangements had also been made for a recently employed member of staff to complete her statutory training. Staff have also completed more specialised training, which enables them to meet the individual needs of people living at the home. For example, one member of staff has completed training in speech and language therapy, communication skills and the Mental Capacity Act. Of the two relatives who returned surveys: • • One person said that the care team has the right skills and experience to look after their relative. This person also said that staff were ‘always’ able to meet the different needs of people using the service; The other person said that the care team ‘sometimes’ had the right skills and experience. This person also said that staff were ‘usually’ able to met peoples’ differing needs. Staff have received supervision at least six times during the last 12 months. A written record has been kept of each session held. Of the staff surveys returned: Warwick Road, 4 DS0000000358.V351105.R01.S.doc Version 5.2 Page 25 • • • • • • • • Four people said that their employer had carried out checks, such as obtaining a Criminal Records Bureau Disclosure check and written references; One person said that their induction training had covered ‘everything’ they needed to do their job when they started. Two said that this was ‘mostly’ the case and one other said that this had ‘partly’ been done; Four people said that the training they received was relevant to their role and helped them to understand the needs of the service users they cared for; Four people said that the training they received kept them up to date with new practice; Four people said that they met with their manager on a regular basis; One person said that the ways of passing information between staff ‘always’ worked well. Two people said that this was ‘usually’ the case. One person said that this was ‘sometimes’ the case; Three people said that there are ‘usually’ enough staff on duty to meet the needs of those individuals living at the home. One person said that this was ‘never’ the case; Four people said that they had the right experience and knowledge to meet the different needs of people living at the home. Warwick Road, 4 DS0000000358.V351105.R01.S.doc Version 5.2 Page 26 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. There are suitable arrangements for keeping peoples’ money and valuables safe. This means that people living at No 4 Warwick Road can be sure that their money and financial interests are being safeguarded. EVIDENCE: The manager is in the process of obtaining relevant qualifications in care and management. Ms Wilcox has worked at the home for approximately seventeen months. All her statutory training is up to date and she has completed inhouse training in areas such as ‘Managing your Work for Success’. Ms Wilcox displays the professional competence required to manage No 4 Warwick Road. Warwick Road, 4 DS0000000358.V351105.R01.S.doc Version 5.2 Page 27 Staff surveyed said: • • ‘The manager is very supportive towards our needs’; ‘She (the manager) always supervises me and makes sure I get the support I need’. The home has taken on day-to-day responsibility for overseeing peoples’ money. Each person’s money is kept separately and is securely stored. Staff signatures are obtained for any money spent on behalf of people living at the home. Receipts are attached to peoples’ financial balance sheets. Financial records show evidence of regular audits. The manager acts as an ‘appointee’ for all of the people living at No 4 Warwick Road. The provider has developed an action plan aimed at promoting equality and anti-discriminatory practice. Systems have been put in place to monitor dayto-day practice against the provider’s plan. For example, job applicants are required to complete equality monitoring questionnaires. The quality of care and services provided at the home are monitored on a number of different levels. For example: • • • Each year quality questionnaires are issued to peoples’ relatives and other professionals visiting the home; Monthly monitoring visits are carried out and review the home’s practice in three areas – support for individuals, health and safety and staff development and competence; Before the inspection, the manager submitted a detailed Annual Quality Assurance Assessment. This document set out what improvements the home intends to make over the next 12 months. A tour of the premises identified no health and safety concerns. Annual risk assessments are carried out in a range of areas such as fire safety and food hygiene. There is an up to date fire risk assessment and an Emergency Personal Evacuation Plan for each person. Fire prevention checks are carried out at the frequency recommended by the local fire service. A range of workplace assessments have been carried out addressing possible risks in areas such as electrical safety and lone working. An independent contractor has tested the home’s water systems for the presence of Legionella within the last 12 months. The home has current gas and electrical safety certificates. Warwick Road, 4 DS0000000358.V351105.R01.S.doc Version 5.2 Page 28 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 3 26 X 27 X 28 X 29 3 30 2 STAFFING Standard No Score 31 X 32 X 33 2 34 3 35 3 36 3 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 2 X 3 X X 3 X Warwick Road, 4 DS0000000358.V351105.R01.S.doc Version 5.2 Page 29 Are there any outstanding requirements from the last inspection? No 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 YA30 Regulation 23(2) Timescale for action Ensure that the corridor and 01/03/08 lounge/dining room carpets are either cleaned or replaced. This will help to ensure that people live in a home that is well maintained and has an attractive appearance. Ensure that: • • All staff receive infection control training; The Department of Health infection control checklist ‘Essential Steps’ is completed; An action plan is devised to address any shortfalls identified. 01/04/08 Requirement 2. YA30 13(4) • 3. YA37 9 Ensure that the registered 01/09/08 manager obtains a recognised qualification in care and management at level 4 or equivalent. Ensure that all staff update their 01/03/08 moving and handling training yearly. 4. YA42 18 Warwick Road, 4 DS0000000358.V351105.R01.S.doc Version 5.2 Page 30 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA34 Good Practice Recommendations Update the Summary of Staff Information Form to include confirmation: • • That the applicant has provided a written statement of their physical and mental health; Of the reasons why a member of staff ended their last period of employment where this involved working with vulnerable adults or children. 2. YA33 Ensure that the home’s rota: • • Includes details of staffs’ designations; Is updated to reflect any changes made because of staff sickness or other unforeseen circumstance. Take every possible action to avoid staff working: • • A 16 hour shift especially where this involves working an evening shift followed by a waking night; 70 hours over eight waking nights. Warwick Road, 4 DS0000000358.V351105.R01.S.doc Version 5.2 Page 31 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR 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, 4 DS0000000358.V351105.R01.S.doc Version 5.2 Page 32 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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