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Please note that the information on this website is now out of date.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 13/06/07 for 2 Princess Close

Also see our care home review for 2 Princess Close for more information

This inspection was carried out on 13th June 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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

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

2 Princess Close provides a comfortable and homely environment. It has been home for some of the individuals for many years. Staff have good relationships with relatives. Feedback from relatives comment cards was that the individual`s needs are met and that the home communicates any changes. The home`s administration of medication is well managed.

What has improved since the last inspection?

Individuals living in the home can be confident that there are clear plans of care in place that demonstrate that the home is meeting their changing needs. Individuals can be assured that their safety is paramount in that there are guidelines to minimise risks as identified at the last inspection. Individuals have been consulted about their leisure activities and further work is being completed to seek appropriate and meaningful occupation within the local community. There are now guidelines in place for helping individuals when they are agitated. These were person centred and used positive techniques to relieve the individual`s anxiety. Individuals can be confident that staff have undertaken training in adult protection and the procedure to follow in the event of an allegation of abuse. One particular individual has been risk assessed in relation to the bathing with clear guidelines being available to staff. A training plan has been developed for the team individually and collectively to ensure that staff are competent and have relevant skills to support the individuals living at 2 Princess Close. Individuals and staff have benefited from a more open and inclusive environment.

What the care home could do better:

Individuals would benefit from all care documentation being dated and signed which would demonstrate that it is current and relevant to the individual. Individuals would benefit from the contract of service being user-friendlier. An individual`s plan of care and the use of restraint must be reviewed with a more positive approach adopted as advised by a visiting specialist. The home and the organisation should review the funding of the mobility vehicle to ensure that it is fair and is agreed by individuals. Individuals must be assured that they are protected from the risk of scalding by hot radiators. The organisation should complete a review of their policies and procedures to ensure that they are still current following some changes in the underpinning legislation.Individuals must be assured their safety in the event of a fire with staff having their competence routinely checked via training and drills.

CARE HOMES FOR OLDER PEOPLE Princess Close 2 Princess Close Keynsham Bath & N E Somerset BS31 2NG Lead Inspector Paula Cordell Key Unannounced Inspection 13th June 2007 09:30 X10015.doc Version 1.40 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 Princess Close DS0000008176.V343177.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 Older People. 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. Princess Close DS0000008176.V343177.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Princess Close Address 2 Princess Close Keynsham Bath & N E Somerset BS31 2NG 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 9077222 0117 9699000 www.brandontrust.org The Brandon Trust Ms Heather Hinton Care Home 5 Category(ies) of Learning disability (5), Learning disability over registration, with number 65 years of age (5) of places Princess Close DS0000008176.V343177.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th January 2007 Brief Description of the Service: 2 Princess Close is a detached house, situated in a quiet cul-de-sac, in a residential area of Keynsham. The house has been extended to provide accommodation for five people with learning disabilities. There is currently full occupancy. There is an agreed variation in the conditions of registration permitting the accommodation of a named service user under the age of 65. On the ground floor there is a lounge, kitchen and dining room. Also on this floor are two bedrooms, a toilet, utility area, and a walk in shower. There is a stair lift to the first floor where there are three bedrooms, a large fourth room currently used as a staff sleep-in/meeting room and a small office space. There is also a bathroom with specialist bath and separate toilet. At the rear of the property there is a patio and small garden that can be accessed by means of a ramp. The home is within easy access of local amenities that include a leisure centre, shops and a park. There are accessible transport routes to Bath and Bristol by both bus and train, and there are bus routes to other local areas. Charges range from £682.60 to £931.91 Princess Close DS0000008176.V343177.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced visit to the service. The purpose of the visit was to monitor the progress to the requirements and requirements from the last inspection in January 2007 and to review the quality of the care provided to the 5 people living at 2 Princess Close. There have been no complaints received by the Commission for Social Care Inspection since the last visit in January 2007. The inspection methods used included record checks, case tracking, and discussion with the manager, two staff, and people who use the service. The home has been sending information in respect of regulation 37 notices of events affecting the well being of the people who use the service. These were used as a focus for the site visit, along with the annual quality assurance selfassessment completed by the home and comments from relatives (2) and visiting professionals (3). The visit was conducted over a period of six hours and ended with structured feedback. What the service does well: What has improved since the last inspection? Individuals living in the home can be confident that there are clear plans of care in place that demonstrate that the home is meeting their changing needs. Individuals can be assured that their safety is paramount in that there are guidelines to minimise risks as identified at the last inspection. Princess Close DS0000008176.V343177.R01.S.doc Version 5.2 Page 6 Individuals have been consulted about their leisure activities and further work is being completed to seek appropriate and meaningful occupation within the local community. There are now guidelines in place for helping individuals when they are agitated. These were person centred and used positive techniques to relieve the individual’s anxiety. Individuals can be confident that staff have undertaken training in adult protection and the procedure to follow in the event of an allegation of abuse. One particular individual has been risk assessed in relation to the bathing with clear guidelines being available to staff. A training plan has been developed for the team individually and collectively to ensure that staff are competent and have relevant skills to support the individuals living at 2 Princess Close. Individuals and staff have benefited from a more open and inclusive environment. What they could do better: Individuals would benefit from all care documentation being dated and signed which would demonstrate that it is current and relevant to the individual. Individuals would benefit from the contract of service being user-friendlier. An individual’s plan of care and the use of restraint must be reviewed with a more positive approach adopted as advised by a visiting specialist. The home and the organisation should review the funding of the mobility vehicle to ensure that it is fair and is agreed by individuals. Individuals must be assured that they are protected from the risk of scalding by hot radiators. The organisation should complete a review of their policies and procedures to ensure that they are still current following some changes in the underpinning legislation. Individuals must be assured their safety in the event of a fire with staff having their competence routinely checked via training and drills. Princess Close DS0000008176.V343177.R01.S.doc Version 5.2 Page 7 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. Princess Close DS0000008176.V343177.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Princess Close DS0000008176.V343177.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4,5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Information was available to individuals living at Princess Close about the service provision. Individuals can be confident that their assessed care needs are kept under review and other professionals are involved in the planning of the care. EVIDENCE: The home has a statement of purpose and a service user guide. These met with the National Minimum Standards and the Care Home Regulations. The Service User Guide was available in plain English and contained photographs making it more accessible to the individuals living at Princess Close. Princess Close DS0000008176.V343177.R01.S.doc Version 5.2 Page 10 The manager stated that as part of the home’s business plan that this information would be made more accessible including an audio version. This would be good practice. There have been no new persons admitted to the home in the last two years. There was documentation in place that evidenced that the home had completed a thorough assessment including obtaining the local authority assessment and care plan of the individuals prior to them moving to Princess Close. Information about the assessment process is made available to individuals in the statement of purpose and in the organisational policy. According to this documentation individuals would be offered a trial period prior to making a decision on whether to move to the home. It was evident from talking with staff and the manager that the individual’s needs are kept under review to ensure that the home remains suitable. The individuals living at Princess Close are getting older which has meant that their needs have changed. It was evident that this was being closely monitored. One person has recently been reassessed to ensure that the home is suitable with consideration being taken to whether this person required nursing care. This was undertaken by the local Community Learning Disability Team, however from talking with the manager and reading correspondence this had not been fully concluded and there is still an expectation that a social worker must complete an assessment and make a decision on the response and assessment conducted by the Community Learning Disability Team. The manager confirmed that the person is well at present and has made a remarkable recovery in relation to their health but could foresee that if their health deteriorated rapidly as before then the home would have difficulty in meeting their needs. Care documentation identified that individuals are referred to specialist services if required. Individuals have a contract of care, however this information was not accessible to some people with a learning disability. Consideration should be taken to make this information user-friendlier. Princess Close DS0000008176.V343177.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Individual’s personal and health care needs are being met. An individual’s safety and liberty is being compromised by the use of inappropriate restraint. EVIDENCE: Individuals have a service user plan containing valuable information about the person to enable the staff team to support them. The files were logical and evidenced that the documentation had been kept under review. However, whilst the documentation showed that this was current it lacked a staff signature and a date. The manager stated that she was reviewing the documentation on the computer and was now incorporating a date and a place for staff to sign. Princess Close DS0000008176.V343177.R01.S.doc Version 5.2 Page 12 The home operates a key worker system (a named worker allocated to a specific person receiving a service). Staff and the individuals living in the home confirmed this. One of the key worker roles was to review the plan of care on a monthly basis and provide a summary of events. This was informative and covered aspects of daily living including general health, social and contact with friends and family. The home has responded to a requirement from the inspection in January 2007 to ensure that care plans are current and are meeting changing needs and kept under review. Risk assessments were in place covering a wide range of activities in the home and the local community, including falls. Individuals in the home vary in their ability to communicate. The manager stated that a new approach was being implemented for one individual, which would enable them to make a variety of choices using photographs. The key worker confirmed that they were in the process of organising taking of the pictures to ensure that they had real meaning for the person. A speech therapist had raised a concern that the home did not act upon their advice and staff had not been consistent in their approach. The manager stated that the home was working closely with the professional to address this. This will be followed up at the next visit to the home. Staff confirmed that they had received makaton training (a sign language for individuals with a learning disability) to support another individual. The inspector was concerned that the home was using restraint for one individual when using the toilet even though an occupational therapist in March 2007 had advised them that this was not satisfactory. The occupational therapist had given advice on a more appropriate solution to ensure the individuals safety but this had not been acted upon. Whilst the home had clearly documented the need for the restraint in the individual’s risk assessment this practice must cease and the advice of the occupational therapist must be followed. Comment cards returned from relatives confirmed that they are kept informed of important matters and they are satisfied with the overall care provided. People have a Health Action Plan detailing their support needs. Evidence was provided that individual’s personal and health care needs were being met. Two of the individuals were being supported to visit the dentist. Princess Close DS0000008176.V343177.R01.S.doc Version 5.2 Page 13 One comment card from a visiting professional highlighted a concern about confidentiality and that personal information was conveyed in the main lounge in front of the other people receiving a service. The manager stated that meetings can be conducted in private in the office upstairs and this issue would be addressed and conveyed to the staff team. During the inspection conversations of a confidential nature were discussed in private and individuals were included in the conversation if conducted in the lounge. One individual was asked their permission as to whether their health care needs could be discussed with the inspector. Medication Administration met with the National Minimum Standards. Records were complete and contained appropriate information and signatures. Staff competence was routinely checked and further training was being provided to ensure that staff had the appropriate knowledge. The manager stated that all staff would be completing a National Vocational Qualification at level 3 in administration of medication. This will be followed up at the next visit to the home. The standard relating to Death and dying was not inspected on this occasion and will be a focus of the next inspection. Princess Close DS0000008176.V343177.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Activities are being offered to individuals based on their preferences and support is given to maintain contact with family. Individuals are supported to make choices in relation to the food provided. A healthy balanced diet is provided. EVIDENCE: Information in care records evidenced that individuals were supported to access meaningful activities. One individual attends a day centre three days per week. Four of the individuals have reached retirement age and have a mixture of external day care and college courses. The manager and a member of staff stated that regular outings are offered but often declined by some of the individuals who prefer to spend time listening to music, watching television and relaxing in the home. It was acknowledged that the individuals are getting older and may prefer to spend time in their home. Princess Close DS0000008176.V343177.R01.S.doc Version 5.2 Page 15 A member of staff stated that the home is actively seeking age appropriate activities including luncheon clubs and drop in centres which maybe relevant to some of the individuals. Recently one of the individuals has started going to a regular church meeting on a Sunday and this appears successful. Another individual attends skittles once a month and another individual is offered a weekly pub outing. Individuals confirmed the activities were taken place. Two of the individuals have had a holiday in Minehead and further holidays are planned with two of the individuals being supported to have regular day trips in line with their preferences. It was evident that activities were linked to preferences and individual needs. An individual was observed enjoying listening to music. It was evident that they felt relaxed in their home. Another individual was being supported to complete their laundry, another was out with staff for a ride in the vehicle and another was out at their cookery class. It was evident that it was a busy day with staff having good organisational skills to ensure that individuals had opportunities to go out and attend day care or appointments. All individuals had an opportunity to go out on the day of the visit. A member of staff stated that the aim is for all individuals to be given an opportunity to go out on a daily basis. Trips include visits to garden centres or the local shopping centre in Keynsham or the local café. Individual’s views have been sought on activities, menu planning, and holidays and staff recruitment as evidenced via the house meetings minutes. Minutes confirmed that these take place every four to six weeks. Other matters discussed were fire evacuation and the complaints policy. The manager stated as part of the home’s business plan a community-mapping tool would be completed to look at the local area for activities and link people up with other people with similar interests. This is being completed over the next few months and training has yet to be given to staff. This will be followed up at the next inspection. Contact with relatives is maintained as evidenced via conversations with individuals, staff and the manager. This was clearly documented in the plan of care. Care planning documentation included information on the support needs of individuals during meal times. Risk assessments were in place minimising the risks of choking. A specialist service has also been involved in advising staff in methods of approach. Princess Close DS0000008176.V343177.R01.S.doc Version 5.2 Page 16 The menu demonstrated that individuals had a varied and healthy diet. A large fruit bowl was available to individuals living in the home. Throughout the visit individuals were being offered a choice of refreshments. One individual stated that they occasionally help prepare the food and that food provided was good with preferences being catered for. This was further evidenced in the house meetings when individuals were consulted on the planning of the menu. The manager was able to demonstrate that the menu included the individual preferences. Princess Close DS0000008176.V343177.R01.S.doc Version 5.2 Page 17 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Systems are in place to ensure that individuals can voice their concerns and which offer protection. However, there are concerns about the funding arrangements of the vehicle, which is being used by all the individuals. EVIDENCE: The home has an organisational complaint policy that indicates the time scales to respond to complaints. Copies of the complaints policy was seen in the bedrooms of the individuals. An individual stated that she was happy living in the home but would talk to staff if this changed. Whilst another stated that they did not like living in the home or the other individuals. The manager stated that this was being explored and an independent advocate was being sought for the person to fully explore what their wanted. There have been no complaints since the last inspection when the Brandon Trust had completed an investigation into concerns raised by a staff member. Princess Close DS0000008176.V343177.R01.S.doc Version 5.2 Page 18 The outcome of the complaint was that although certain aspects of the home’s practices need to be reviewed and changed to reflect both good practice and a positive culture, generally individual’s best interests are considered highly. From conversations with the manager and staff it was evident that the home has reviewed some of the practices and moved the home forward. Policies and procedures relating to the protection of vulnerable adults were seen at previous visits and linked with the Department of Health’s policy on “No Secrets”. The manager and staff spoken with described the content and the procedure to follow in the event of an allegation of abuse. The manager has devised a plan to ensure that all staff have attended an appropriate course on protection from abuse and the policy was discussed at a recent team meeting including the Whistle Blowing Policy. A member of staff confirmed that they were attending an alerter course the week after the visit and abuse had been covered during their induction. The home has policies and procedures relating to the financial affairs of the individuals. Good practices are adopted in the home to ensure that the individual’s monies are protected. However, concerns are raised relating to the funding of the mobility car. One of the individuals funds this via their Disability Living Allowance and the other individuals pay a minimal amount for petrol, this does not appear equitable or within the agreement of the mobility car scheme which clearly states that the car should only be used by the named person. The home is following the organisational policy on leasing and mobility vehicles. There are contract agreements in place signed by the individuals living in the home. However, as discussed with the manager it is debateable whether the individuals could consent or have the full understanding of the financial implications. This system of funding a home’s vehicle should be reviewed to ensure that it is equitable and that a third person independent of the home and the organisation assists with the agreements. From observations and conversations with the manager and an individual receiving a service it is evident that staff have to support an individual who at times can make allegations. It is evident that the home records and takes seriously these statements and liaises with the appropriate people. An allegation was made to the inspector about a member of senior staff shouting on the morning of the visit. Both staff spoken with confirmed that the individual was upset however, both staff were clear that shouting was not appropriate and was abusive. The manager stated that safeguards are put in place for the staff and the individual and this is clearly documented in the individual’s plan of care and all allegations are recorded. Princess Close DS0000008176.V343177.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Princess Close provides individuals with a homely and comfortable environment, which is meeting their changing, care needs. EVIDENCE: The home is in keeping with the local neighbourhood and is near to local shops and amenities. There are bus services available for access to other local towns, Bristol and Bath. The home provides a suitably furnished environment that meets the needs of the individuals. Great attention has been taken to personalise the home. All areas of the home were clean, hygienic and odour free. Princess Close DS0000008176.V343177.R01.S.doc Version 5.2 Page 20 Suitable aids and adaptations were available to assist the individuals with their personal care including a walk in shower (wet room) and a high low bath with built in hoist. Evidence was provided that equipment was routinely checked and maintained. Occupational therapists had been involved in the assessment of equipment as evidenced in care records. The manager has made a suggestion to the organisation that a conservatory be placed to the rear of the property to offer more communal space. This would be beneficial as the lounge is on the small size for five people including mobility aids. This would offer individuals an additional quiet space to relax. Routine maintenance records evidenced that there was a prompt response to repairs. Routine checks on the electrical equipment, the stair lift, gas and fire detection were taking place ensuring that the home was a safe place to live and work. Princess Close DS0000008176.V343177.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 26,27,28,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are sufficient staff on duty in the home at all times. However, there has been a high turnover of staff and this could be detrimental to the care of the individuals living at Princess Close. Staff are competent to meet the needs of the individuals living in the home and this will be enhanced with the core training being completed which links to the needs of the individuals. EVIDENCE: The rota provided evidence that the home is staffed according to the statement of purpose and the needs of the individuals living in the home. There are always two staff on duty during the day and the evening with one member of staff providing sleep in cover. Princess Close DS0000008176.V343177.R01.S.doc Version 5.2 Page 22 The manager stated that the home has 6 staff working in the home with a vacancy of 52.5hours, which at the end of the month will increase to 90 hours as one staff member is transferring to another home. The manager and a member of staff stated that the shortfall is being covered by a regular bank staff who is familiar to the individuals living at Princess Close, and the staff team working additional hours. A recruitment initiative is taking place in the local area to actively recruit new and local staff to the home. People who receive a service have been consulted about the interview and what they feel is important in relation to staff. Each person has devised a question that they feel is relevant to be asked at the interview. This is good practice. Recruitment information is held at Brandon Human Resource Department and will be subject to an inspection to ensure that an appropriate and thorough recruitment process has taken place. The home has an organisational induction, which includes elements of health and safety training, aims and values of the service and protection from abuse. Staff complete the Learning Disability Award Framework and an in-house induction. Staff confirmed that they had read key policies and procedures and care planning information as part of their induction. Once staff complete their induction they progress to complete a National Vocational Award in care. Two staff presently have a National Vocational Qualification (NVQ) at level 2 in Care, with a further member of staff in the process of completing this. The home is working towards the government target of 50 of the workforce having an NVQ 2 or equivalent in care. The training matrix provided evidence that all staff have attended their statutory health and safety training, including first aid, food hygiene, annual fire training and manual handling. Other areas of training included epilepsy, communication, person-centred planning, supporting the older person and understanding dementia training. The manager stated that the home has identified some core training for staff including care of the elderly, person centred planning and report writing and staff will be attending this training this year but as yet no dates have been confirmed. The home has demonstrated compliance to a requirement from the visit in January 2007. Brandon Trust have available to staff a prospectus of training and staff are now being encouraged to attend courses. Princess Close DS0000008176.V343177.R01.S.doc Version 5.2 Page 23 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Individual’s benefit from a home that is well managed. Improvements have been made to ensure that the service is inclusive of both the staff and the individuals. Individual’s safety is being compromised in the event of a fire and there is a risk of scalds from radiators. Princess Close DS0000008176.V343177.R01.S.doc Version 5.2 Page 24 EVIDENCE: Ms Heather Hinton is the registered manager. Ms Hinton has a social work background and qualification and has completed her NVQ 4 in care and Registered Managers Award. Ms Hinton is an NVQ assessor. The manager stated that further training is planned on the Mental Capacity Act and Equalities and Diversity. From discussions with staff and observations of her interactions with people who use the service she is open and inclusive. Staff spoken with stated that she is open to ideas and suggestions and is keen to include people who use the service in the running of the home. This was further evidenced in staff and house meeting minutes, which take place every four to six weeks. Ms Hinton stated that she is presently reviewing her management hours and is planning that some of her shifts are in addition to the staffing numbers to free her to complete some of her management responsibilities. This would be good practice. There are organisational policies in place to guide staff. It was noted that some of these are dated 1996 including Manual Handling Guidelines, Sexuality and Relationships and the policy relating to Staff disciplinary and Grievance. These would benefit from a review because some of the associated legislation has changed. There are organisational policies and procedures in relation to financial affairs. A check on three people’s finances indicated that the policies and procedures were being followed. Amounts held in the home corresponded with the records. Individuals have their own bank account and records are maintained of all transactions. The finances of the homes are scrutinised via the monthly provider visits and periodically by an external auditor. The latter was completed in January 2007, the manager stated that she has not received a report of this visit but there were no requirements or recommendations. From reading the fire logbook it was evident that the appropriate checks were taken place on the fire equipment. Less apparent was fire training 3 monthly for night staff and six monthly for day staff, however staff had discussed the fire evacuation policy in January 2007 and had attended an annual fire training course in August 2006. The manager stated she was not aware of this requirement and would now put it in place. In addition 3 members of staff have not attended a drill in the last twelve months and 3 in the last seven months. All staff must attend a fire drill once in a six-month period. Princess Close DS0000008176.V343177.R01.S.doc Version 5.2 Page 25 Risk assessments were in place for manual handling, fire and substances hazardous to health (COSHH) and had been periodically reviewed. Other areas that demonstrated that health and safety was paramount, was the routine checks on aids and adaptations, the landlords gas certificate, electrical equipment testing and the routine environmental checks. Staff complete routine checks on hot water supplies and food temperatures. These were satisfactory. A concern was raised that some of the radiators had been fitted with safety guards mainly in the bathrooms and the toilets but not in bedrooms or communal areas and there could be a risk of scalding. This must be risk assessed to ensure the safety of individuals. Where a risk is identified then appropriate action must be taken. The provider is completing the monthly visits in respect of regulation 26 and copies are being sent to the Commission for Social Care Inspection. In addition the home is informing the Commission for Social Care Inspection of events that affect the wellbeing of the individuals living in the home. Princess Close DS0000008176.V343177.R01.S.doc Version 5.2 Page 26 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 2 X 2 Princess Close DS0000008176.V343177.R01.S.doc Version 5.2 Page 27 Are there any outstanding requirements from the last inspection? Yes 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. 2. Standard OP1 OP7 Regulation 5 (b) 12 (1) (b) 13 (4) Requirement For the organisation to review the contract of care to ensure that it is service user friendly. To review the use of restraint in respect of one individual following the advice of the visiting specialist. Risk assess radiators in the home and where a potential risk is identified the home to take appropriate action. To ensure that the requirements of the Regulatory Reform (Fire Safety) Order 2005 are met in respect of fire training and fire drills. All staff to attend a fire drill once in six-month period. Training in fire prevention 3 monthly for staff working nights and six monthly for day staff. Timescale for action 13/09/07 26/06/07 3. OP38 13/07/07 4. OP38 24 (4A) 13/07/07 Princess Close DS0000008176.V343177.R01.S.doc Version 5.2 Page 28 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 OP7 Good Practice Recommendations Sign/date documentation in service user care plans in order to monitor changes. (Outstanding since January 2007) To review the funding arrangements for the motability care ensuring that it is equitable and that consent has been sought from the individual or their representatives. For the organisation to keep under review the policies and procedures – firstly prioritising the Manual Handling, Sexuality and Relationships and Staff Grievance and Disciplinary Policies as these are dated 1996. 2. 3. OP18 OP36 Princess Close DS0000008176.V343177.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG 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 Princess Close DS0000008176.V343177.R01.S.doc Version 5.2 Page 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!