Inspection on 09/11/07 for 1-3 Robin Close

This inspection was carried out on 9th November 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

1-3 Robin Close 14/12/09

1-3 Robin Close 08/01/07

1-3 Robin Close 13/04/06

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 2-3 Robin Close Westbury On Trym Bristol BS10 6JG Lead Inspector Vanessa Carter Key Unannounced Inspection 9th November 2007 09:30 2-3 Robin Close DS0000063643.V348434.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 2-3 Robin Close DS0000063643.V348434.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. 2-3 Robin Close DS0000063643.V348434.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 2-3 Robin Close Address Westbury On Trym Bristol BS10 6JG 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) 0117 9494942 None United Response Mr Simon Charles Phillimore Care Home 7 Category(ies) of Learning disability (7), Learning disability over registration, with number 65 years of age (2) of places 2-3 Robin Close DS0000063643.V348434.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. May accommodate up to 7 persons aged between 18-65 with learning disabilities May accommodate 2 named persons aged over 65 with learning disabilities Planned alterations to House Number 3 will be completed by the end of November 2006 Planned alterations to House Number 2 will be completed by the end of April 2007 8th January 2007 Date of last inspection Brief Description of the Service: Numbers 2 and 3 Robin Close provide placement for 7 people, three in number 3 and four in number 2. Both properties are identical, are two storey and are approximately 15 years old. Until July 2005, the properties were both owned and managed by the National Health Service (BaNES PCT) Both properties have recently been refurbished and will now transfer to Golden Lane Housing Association, with the care services continuing to be provided by United Response. United Response is a national charity, and the base in Chippenham provides area and divisional functions. Number 1 Robin Close remains with the NHS. The properties are located within their own gardens but these are currently under-developed. Now that the internal works have been completed, planning will begin in the spring to address this shortfall. The home offers placement to both male and female residents aged between 18-65 years with a learning disability. The Primary Health Care Trust pays for the current residents to live at the house. United Response has produced a Statement of Purpose and this will inform any prospective residents about their service. 2-3 Robin Close DS0000063643.V348434.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The key inspection was unannounced and took place over one day. All standards were assessed. Evidence to form the report has also been gathered from a number of other sources:Information provided by the home manager in the Annual Quality Assurance Assessment (AQAA) Talking with the home manager and one of the deputy managers Observation of staff practices and their interaction with the residents A tour of the home Case tracking the care of a number of residents Talking with a number of the residents Speaking with some staff Speaking with relatives Looking at some of the homes records Information supplied by residents (3), relatives (6), in CSCI survey forms Information supplied by one GP surgery. Since the last inspection in January 2007, both houses have been fully refurbished. Whilst the building works were going on, the residents moved out and lived elsewhere in alternative residential accommodation. The seven residents have all returned to live at Robin Close and it appears that the move has been managed well and the residents have coped remarkably well. What the service does well: Information produced about the home, and their assessment processes, will ensure that those residents who live in this home, are looked after as they wish and get the care they need. The homes care planning processes ensure that each resident has a say in how they want to be cared for. Risk assessment processes will safeguard residents but will not prevent them from experiencing new situations. Vast improvements have been made for residents to develop to their full potential, and to have a life style of their choosing. This means that their quality of life is better, and enables them to fulfil their aspirations. Residents receive the support they need with their personal and healthcare needs. Medication systems are safe. Good procedures are in place to ensure that residents and their representative’s, can raise any concerns and that residents are safeguard from harm. 2-3 Robin Close DS0000063643.V348434.R01.S.doc Version 5.2 Page 6 The staff team are skilled and knowledgeable therefore residents can expect to be well cared for. The staff team are well supported and supervised. The home has a strong management team with effective leadership and it is well run. The home is run in the best interests of the residents and the staff do their best to capture the views of the residents. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. 2-3 Robin Close DS0000063643.V348434.R01.S.doc Version 5.2 Page 7 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 2-3 Robin Close DS0000063643.V348434.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4 and 5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Information produced about the home, and their assessment processes, will ensure that those residents who live in this home, are looked after as they wish and get the care they need. EVIDENCE: The home’s Statement of Purpose is in the process of being updated to include the changes in the living environment that have recently been made. The manager explained that the room sizes have just to be added to complete the document. Despite this the document reflects the service that is offered, and the quality of life that each resident can expect to have. Residents are each provided with a service user guide – this is presented in a format using simple words and pictures. This will mean that the residents are fully aware of their rights and how to raise any concerns that they may have. The home continues to be fully occupied, with the seven residents having lived together for many years. The assessment processes for four residents (two from each house) were looked at to determine how the home identifies and then plans the care for each individual resident. The home has a comprehensive assessment tool that includes looking at a wide range of needs – level of support needed with personal care tasks, continence, eating and drinking, behavioural traits and health needs. 2-3 Robin Close DS0000063643.V348434.R01.S.doc Version 5.2 Page 9 The assessments are written up as a Support Plan and are further supported by individually prepared risk assessments. It is not predicted that a vacancy will become available in the near future however the proposed admission procedure would involve the gathering of information from family, healthcare and social care professionals, as well as the home manager undertaking a full care needs assessment. Prior to admission to the home a number of transitional visits would be arranged, so that compatibility with the other residents is measured. This may initially be a “meal time” visit, increasing to a number of hours, to a sleepover and then a weekend stay. The current group of residents are funded by the PCT, therefore any contract is between them and the service provider. The residents would not be able to understand the terms of any contract. 2-3 Robin Close DS0000063643.V348434.R01.S.doc Version 5.2 Page 10 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, 8 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The homes care planning processes ensure that each resident has a say in how they want to be cared for. Risk assessment processes will safeguard residents but will not prevent them from experiencing new situations. EVIDENCE: Four of the residents’ files were looked at, two from each house. For each there was a very detailed plan of care, written in the first person and containing a lot of information based on an extensive knowledge of the person. The plans were person centred – “my food needs to be cut up as I eat fast” and “0ffer to help me but if I say No, do not insist”. Each resident’s plan of care covers personal and social support, what healthcare needs they have, and any plans for the future. There was evidence that the plans were drawn up with the involvement of the resident together with family and/or relevant agencies. The plans are reviewed on at least a six monthly basis, and amended where necessary to reflect any changes. 2-3 Robin Close DS0000063643.V348434.R01.S.doc Version 5.2 Page 11 There has been a significant improvement in the home care planning processes since the last inspection and this will benefit the residents by ensuring that they get the individual care that they require. The residents are each encouraged to make decisions about their lives and observations made during the inspection, were of the support workers working alongside the person they were looking after, supporting them to make decisions for themselves. The care plans are supported by a number of risk assessments. These may be around the management of violent outbursts or road safety. The risk assessment may refer to “visible signs that may show I am not in full charge of myself”, or state whereabouts in the minibus transport they should sit for safety reasons. Risk assessments had been prepared for one resident to undertake an external social activity and this was being tweaked to reflect the new challenges that were being presented. This is good practice and evidences that resident and staff safety is paramount. The fact that the residents in house 3 now live separately, in self-contained flats, means that they are able to live as individuals and receive support from designated support workers. These changes to their living environment have meant that their individual needs and their choices are at the forefront of care planning. 2-3 Robin Close DS0000063643.V348434.R01.S.doc Version 5.2 Page 12 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, 14, 15, 16 and 17. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Vast improvements have been made for residents to develop to their full potential, and to have a life style of their choosing. This means that their quality of life is better, and enables them to fulfil their aspirations. EVIDENCE: Each of the residents has a weekly programme of activities. This may include attendance at a local authority day care centre, hydrotherapy sessions, individual trips out for shopping, meals or the cinema, and going along to various clubs. A really significant improvement has been made for two of the residents – one now attends college and another has paid employment. This is evidence that the home supports and enables the residents to personally develop their skills. Other examples where residents have been helped to develop their skills involves the engagement of residents in household tasks such as helping with their own laundry or making a cup of tea. 2-3 Robin Close DS0000063643.V348434.R01.S.doc Version 5.2 Page 13 In addition to “in-house” support workers others are provided by another service provider, and will work with individual residents and undertake activities of their choosing. Residents are encouraged and assisted to pursue their own interests and hobbies. There is an increasing use of local community resources and a greater commitment by the staff to enable the residents to participate in any new experiences. One resident is supported to maintain links with their culture by being supported and enabled to attend social functions that meet this need. This is commendable. Two of the residents have had holidays this year, for one, the first in many years. The two residents did not holiday together, and the plans were made around each individual’s own preferences. One went to Cornwall – “Why Cornwall” - “someone suggested it and I never been there before”. The holiday photographs were proudly shared. For those residents where a long break away is not suitable, day trips are arranged. Residents are encouraged to maintain contact with family, and staff will assist with the making any of the necessary arrangements. The home have recently supported one of the residents to attend and play an active role in a family celebration, the relatives commented “ it was greatly appreciated by the whole family how helpful the home was. Mr Phillimore totally supported the idea”. Discussion with the manager evidenced that the home will go to any length necessary to enable the resident to visit their family or for the family to visit the home. Residents are consulted before anyone goes into their private room – two residents were asked if their rooms could be entered during the inspection. Each room is lockable and the resident is able to choose whether to have a key or not. Residents were observed moving about in the home independently and staff were conversing with them appropriately. The home has a menu plan but this was not inspected on this visit. Where appropriate, records are kept of foods offered and taken. For a number of the residents, the home monitor body weight to ensure that the resident receives adequate nutrition. Where they cannot measure actual body weight, the home records girth measurements on a monthly basis. This evidences that the home take seriously their responsibility in ensuring that the residents are well fed. Six of the seven residents were seen during the inspection and each looked healthy – this was particularly noticeable for one resident. Mealtime arrangements for the three residents in house three are now much improved since they each have their own facilities, and eat separately from the other residents. 2-3 Robin Close DS0000063643.V348434.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents receive the support they need with their personal and healthcare needs. Medication systems are safe. EVIDENCE: The manager, the deputy and those staff spoken with during the course of the inspection all demonstrated a very thorough knowledge of each resident’s specific healthcare and personal needs, and could state who liked what and what might cause an upset. All residents are now registered with a new GP, the previous arrangements where the doctor visited the home on a weekly basis, no longer being appropriate. From now on, the residents will individually be supported to go along to the surgery whenever they need medical advice. The GP will only visit the home if a surgery visit is not possible and would only be to see an individual resident. This means that the residents will no longer be treated as “patients” and will be able to access healthcare support the same as anyone else who lives in the community. Evidence was seen in one persons care file of the actions taken by the home manager to ensure that one of the residents received the hospital treatment that they needed. In another residents plan it was written “I have a health condition therefore I need my weight monitored”. 2-3 Robin Close DS0000063643.V348434.R01.S.doc Version 5.2 Page 15 Now that the residents have new medical services, a Health Action Plan for each resident will be discussed in conjunction with the GP. This may involve well-man or well-woman clinics. Staff said that the residents are able to get up and retire to bed, at their preferred time. All seven residents were observed, at different times of the day, moving about the home, or being given guidance where necessary. The residents were each well dressed and looked clean and well cared for. The home keeps a record when healthcare professionals are consulted about the health of the residents, this was recorded clearly and evidenced that residents receive the healthcare support they need. The homes medication procedures are safe, with regular audits being undertaken to check stock levels and the responsibilities for ordering and administrating medications being confined to a limited number of staff. All staff have received training in safe medication administration and this was confirmed by staff training records and discussion with some support workers. The home has a GP agreed list of ‘homely remedies’ that they can administer without prescription (over the counter medications) – this will need to be agreed with the new GP. Medication profiles have been prepared for each resident so that staff will know what each medication if for and what side effects may occur. On the medication administration sheets (MAR sheets) the home should ask the chemist to record why ‘as necessary, or PRN medications’ may be administered and what maximum dosage applies. 2-3 Robin Close DS0000063643.V348434.R01.S.doc Version 5.2 Page 16 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. Good procedures are in place to ensure that residents and their representative’s, can raise any concerns and that residents are safeguard from harm. EVIDENCE: The home has a complaints procedure in pictorial format and this is included in the service users guide that is issued to each resident. The home also displays a copy of their procedure in the communal areas of both houses. Due to the level of the resident’ s individual learning disabilities and communication needs, they are unlikely to raise any formal complaints however each are, in their own way, able to express their unhappiness about any given situation. The manager has dealt with just one complaint from a relative since the last inspection and CSCI have not received any complaints about the service. The manager has demonstrated his ability in ensuring that the residents are protected from abuse, harm or neglect, by the actions he took in two separate situations. The manager worked with local authority personnel in following “No Secrets” procedures, and worked within the agreed strategy plans. There has been a significant drop in the number of incidences of physical aggression and verbal assaults occurring between residents, and this is attributed to the change in living arrangements and because staff no longer accept this as being okay, and take the appropriate preventative action. Staff confirmed that they have had training in adult protection issues, and those spoken with during the inspection demonstrated their awareness of issues and their responsibilities. 2-3 Robin Close DS0000063643.V348434.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are living in a safe and comfortable home, with the recent refurbishment of the houses providing an enhanced environment, which is better suited to their needs. EVIDENCE: Number 2 Robin Close is home for four people. Two of the bedrooms are on the top floor and two are on the ground floor each now has en-suite facilities of either a bath or a shower. The residents chose what they wanted and also picked the colours that their rooms were to be painted. The communal areas in house 2 consist of a large lounge, a smaller quiet room, a dining room, the kitchen and the utility area. There is an additional bathroom and separate toilet on each floor – these are fully assisted for those with a disability. The staircase is the only route between the two floors, therefore not all parts of the home are fully accessible to anyone with impaired mobility. Outside, in a shed there is a pool table 2-3 Robin Close DS0000063643.V348434.R01.S.doc Version 5.2 Page 18 Number 3 Robin Close is home for three people. They live in three selfcontained flats. Entry to the flats is via the communal hallway – this has been decorated in a bland style. Two of the flats are on the ground floor whilst one is on the first floor. Each of the flats has a lounge, bedroom, kitchen and bathroom, and has been adapted to meet the specific needs of the resident. Brightly coloured grab rails have been installed all round one residents flat (sensory and mobility impairment), extra padded flooring installed and robustly designed furniture installed are just some examples of how the home has endeavoured to provide the right, and safe environment for each resident. As part of the refurbishment works a call bell system has been installed in both houses. This means that staff can summon help in an emergency. This is particularly important in number 3 where the resident and support worker is working within a closed environment. Each staff member will have a “panic alarm” on their person whenever they are on duty, although the manager and the staff both agreed that now that things have settled into a routine, the incidences of “challenging behaviour” have lessened, and staff do not always wear their alarms. Both houses were clean and tidy throughout and free from any offensive odours. There are laundry rooms in each house and each resident’s laundry is done separately. A number of residents, with support workers assistance, have started to help do some laundry tasks. The problems noted at the last inspection, with the drainage system at the front between the two driveways has been resolved as part of the building works. The house is surrounded by gardens but these are under- developed. One resident said, “I have pulled up some of the weeds but it all needs clearing”. There are plans that the gardens will be upgraded next year. The manager also said that there were plans to make a sensory garden that would benefit one of the residents who has sensory impairment. 2-3 Robin Close DS0000063643.V348434.R01.S.doc Version 5.2 Page 19 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): 31, 32, 33, 34, 35 and 36. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staff are skilled and knowledgeable therefore residents can expect to be well cared for, but further development is still needed with vocational training. The staff are well supported and supervised. EVIDENCE: Some of the staff team transferred from NHS employment under protected terms and conditions of service, but others have been recruited to join the team. There has been a significant change in the culture of the home and the way in which the staff work. One support worker said, “we are encouraged to think more now about what the resident wants. They are not patients any more”. The home is currently in the process of recruiting an additional six staff – it is identified at interview stage whether applicants are better suited to work in number 2 or number 3. The home uses agency staff to fill some shifts but endeavour to use staff who are familiar with the residents needs. Since the last inspection a deputy manager has been appointed for each house. They each have responsibility for the day to day running of the house, the staff deployment and the residents care and support. One of the deputy managers was on duty during the inspection, has experience in the field of learning disability and has worked for United Response of many years. 2-3 Robin Close DS0000063643.V348434.R01.S.doc Version 5.2 Page 20 Those support workers spoken with during the course of the inspection demonstrated that they are knowledgeable of the resident’s specific needs and have the necessary skills to be able to meet them. Observations of their practice evidenced their commitment to meeting the resident’s individual needs and supporting them to develop the skills to undertake new tasks. The majority of the support workers have already attained an NVQ Level 3 in healthcare related tasks and United Response are in the process of looking for additional training to ensure staff skills are transferred to a social care setting. Some of the newer staff are keen to undertake NVQ training and this was discussed with the manager. In view of the fact that the residents have been decanted and the home has been refurbished in the last year, has meant that the homes progress in meeting NVQ targets has been delayed. There has been a great deal of investment in staff training, examples include the following – first aid, health & safety, prevention from harm, medication, equality and diversity, challenging behaviour, “The way we work” and “engagement” training. The aim of the two specific training courses is to bring about a change in the staff culture and enable them to help the residents reach their full potential. There are plans that the staff group will start training in British Sign Language in the near future – this will enable more staff to be able to communicate with residents who have a hearing loss. Staffing numbers are arranged around residents’ needs and what is planned to happen at any given time. On the day of inspection there was the manager, one deputy plus six support workers on duty. In house 3 each resident is assigned a support worker for the day, plus there is an additional “floating” staff member to assist with any emergencies. In house 2 during the week there are two support workers for all shifts. Over night there are two members of waking staff in each house – all staff do a mixture of night, morning and evening shifts. The staff still work to the same shift patterns that they are used to and these arrangements do impact upon the activities of the residents and can prevent them from participating in some evening recreations. Consideration is already being given to what changes may need to be made. One relative said “social activities may have to be cut short so that staff can go off duty”. The home follows robust recruitment procedures and ensures that the right people are employed at the home. Staff files were not checked as part of this inspection as they are stored at the head offices in Cheltenham. The manager gave assurances that potential staff are interviewed by a panel of interviewers. Satisfactory references, CRB/POVAfirst clearance and medical fitness for the job are all confirmed before employment commences. 2-3 Robin Close DS0000063643.V348434.R01.S.doc Version 5.2 Page 21 New recruits will complete a “Common Induction Standards “(CIS) induction programme at the start of their employment, and will have a six month probationary period to start with. The deputy manager’s are responsible for ensuring that new support workers complete all the components of the induction programme. These arrangements will ensure that all new staff will have the necessary skills and attributes to meet the resident’s needs. Staff supervision is undertaken by the two deputies’ and was confirmed as taking place by those staff spoken with during the course of the inspection. Staff also confirmed that informal management support is available at all times. Out of hours, there in an on-call arrangement for management support – details regarding who is on call is displayed on the office notice boards. 2-3 Robin Close DS0000063643.V348434.R01.S.doc Version 5.2 Page 22 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, 38, 39, 40, 41 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a strong management team with effective leadership and is it well run. The home is run in the best interests of the residents and the staff do their best to capture the views of the residents. EVIDENCE: The registered manager, Mr Simon Phillimore was present during the inspection visit, as was one of the deputy managers. Both cooperated in the inspection process and demonstrated good awareness of the homes procedures and the resident’s needs. Mr Phillimore has been in post since the home transferred from NHS retained services to being a Care Home in 2005. He has previous experience of home management within a United Response social care setting. He is currently undertaking the NVQ Level 4 Registered Managers Award but the completion of this has been delayed due to the decanting and refurbishment works. 2-3 Robin Close DS0000063643.V348434.R01.S.doc Version 5.2 Page 23 Staff spoken with during the inspection were positive about the manager and his style of management, felt supported with the changes in working practice and felt he provided a clear sense of leadership. One support worker said, “our views are valued and we are listened too”. Staff meetings are held on a monthly basis. The home has now achieved its main aim of improving the internal living environment of both houses and strengthening the staffing team, meaning that the residents will be able to live more comfortably and will have an improved quality of life because they are enabled to accomplish more. Both the manager and the staff team, showed how the residents were involved in making decisions about the décor of the home, and the facilities that they wanted included in their living environment. Whilst the manager does have a list of top priorities that includes NVQ training, improving the garden areas and looking at shifts patterns, the service needs to have a quality assurance and monitoring system in place, so they are able to measure their success in achieving the aims and objectives, and statement of purpose of the home. A senior United Response manager visits the home on a regular basis and completes a ‘Regulation 26’ report to monitor the home’s performance. The AQAA (annual quality assurance assessment) returned to CSCI was detailed and listed those areas where they felt they “could do better”, and what their improvement plans were for the next year. The organisation has in place, all the polices and procedures necessary to safeguard and protect the health and well-being of the residents. All the homes records that were seen during the course of the inspection were well maintained, and easily produced upon request. The home has put good administrative systems in place to ensure that all information is readily available. The records of accidents/incidents kept in house 2 were examined and found to be in order – an assumption was made that the records would also be in order in house 3. The home notifies CSCI of any incidences that occur within the home, but CSCI has noted that there has been a significant drop in the number of incidences occurring. All staff receive manual handling training, health & safety and food hygiene training as part of the common induction standards programme but also as refresher training. Staff and records confirmed this. One of the deputy’s is qualified to teach manual handling – the content of her training includes moving people and moving objects. 2-3 Robin Close DS0000063643.V348434.R01.S.doc Version 5.2 Page 24 The fire safety records were in order, and all the necessary weekly, monthly, quarterly and bi-annually checks had been completed. The staff team cover both day and night shifts, therefore all have fire awareness updates on a three monthly basis. The records of other environmental checks, such as fridge and freezer temperature checks, hot water checks, vehicle checks and medication audits, were all in order. The responsibility for these to happen has not been delegated to specific staff but is shared by the whole team. 2-3 Robin Close DS0000063643.V348434.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 3 12 4 13 4 14 3 15 4 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 3 2 3 3 3 X 2-3 Robin Close DS0000063643.V348434.R01.S.doc Version 5.2 Page 26 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 YA39 Regulation 24 Requirement The home must establish and maintain a system for reviewing and improving the quality of care provided. An annual development plan should be devised. Timescale for action 09/05/08 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. Refer to Standard YA1 YA32 Good Practice Recommendations Copy of the updated Statement of Purpose to be supplied to CSCI United Response should look to provide NVQ training for all those staff without level 2 and provide additional training for those with NHS obtained NVQ’s. 2-3 Robin Close DS0000063643.V348434.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection South West Regional Office 4th Floor, Colston 33 33 Colston Avenue Bristol BS1 4UA 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 2-3 Robin Close DS0000063643.V348434.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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