Inspection on 28/09/06 for 21a King Street

This inspection was carried out on 28th September 2006.

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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

21a King Street 02/03/06

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

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

CARE HOME ADULTS 18-65 King Street, 21a 21A King Street HEREFORD HR4 9BX Lead Inspector Christina Lavelle Unannounced Inspection 28th September & 5 October 2006 2:30 th King Street, 21a DS0000066942.V308299.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 King Street, 21a DS0000066942.V308299.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. King Street, 21a DS0000066942.V308299.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service King Street, 21a Address 21A King Street HEREFORD HR4 9BX 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) 01432 269406 01432 344647 Aspire Living Mrs Elizabeth Linda Watkins Care Home 6 Category(ies) of Learning disability (6) registration, with number of places King Street, 21a DS0000066942.V308299.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: N/A Date of last inspection 2nd March 2006 Brief Description of the Service: 21A King Street was first set up as a care home in 1986 by Stonham Housing Association. Aspire Living took over the home’s management in February this year, which is a voluntary organisation and a registered charity. Aspire Living runs ten care services in Herefordshire, which includes eight other care homes and a domiciliary care agency. The home is registered to provide accommodation with personal care for six adults (men and women). Service users must require care due to learning disabilities and most of the current residents have lived at the home for more than ten years. They are all aged over forty and under sixty-five years, but as two people are now in their sixties the home’s categories of registration is being changed to include service users who may also be over sixty five. The property is a Grade II listed Georgian town house, which has three storeys and is located down a short passageway in the centre of Hereford city near the Cathedral. The home is therefore in a convenient place for the shops, services and facilities in Hereford and for getting buses and trains. The house is leased by Aspire Living from a registered social landlord and there is a management agreement in place regarding the use and upkeep of the premises. Service users all have single bedrooms on the first floor, which do not have ensuite facilities. The house has a lounge, kitchen, laundry room and separate dining/sitting room on the ground floor. It also has a cellar (used for storage and as a games room), three bathroom and/or shower rooms and a small, enclosed garden for everyone to use. On the second floor there is an office/sleep-in room, small kitchen, bathroom and separate lounge, which is also used as a meeting room. The current charge for the home is £370.00 a week. Additional costs include hairdressing, chiropody, newspapers, personal toiletries & clothes, activities, dry cleaning, transport and holidays. There is also a 30p a mile charge when staff use their own cars to provide transport for service users. King Street, 21a DS0000066942.V308299.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. These two visits are part of a key inspection of the home. The main aim of this inspection is to check all the Standards that have most impact on the service users. The first visit was made unannounced and three and a half hours were spent talking with service users and staff about the home. The second visit took two and a half hours and was arranged at the first visit so that how the home is being run and any changes and developments could be discussed with the manager. All were very welcoming and gave helpful information. During the visits two support workers were spoken with individually about how they got the job, their experience of working at the home, their training and the support they receive. Several service users were asked their views of the home in private and one of them also showed the inspector around the house. Various records kept about service users’ care, staff and which show how the home and service users are kept safe were also checked. Other information was obtained from a questionnaire the manager completed before the visits about the home and from survey forms service users and their relatives had been sent asking their views of the home. All communication between the home and Commission since the last inspection is also considered. This includes notifications of events that had affected service users and reports made by a representative of Aspire Living following their monthly visits to check the home is being run well. The Commission has not had any complaints about the home and no issues have been raised about service users protection. What the service does well: King Street is in good place in the middle of Hereford city. This makes it easier for service users to use shops, cafes, pubs and go to Church etc. Also to get to their day services, work and to meet up with their families and friends. The house is comfortable, is kept safe and in a good condition and was seen to be clean and tidy. Service users have made their bedrooms nice and personal. There is a warm and friendly atmosphere in the home. Most service users have lived there more than ten years and are well settled. It is good however that one person is thinking about moving to more independent living and staff are supporting them to decide and to arrange this move if it would be suitable. Service users say they are happy living at King Street and mostly get on well with each other and staff. They think that the manager and staff are nice and helpful and could talk to them if they have any problems. Staff also know what to do if there is any concerns. Service users relatives say they are made welcome, are kept well informed and are satisfied with the care in the home. King Street, 21a DS0000066942.V308299.R01.S.doc Version 5.2 Page 6 Service users are encouraged to be independent and say they make their own decisions every day about such as what they do and eat. They share all the jobs around the house, including the cleaning, shopping and cooking, and have a meeting every week to discuss the week’s menus, arrange socials in the home, their outings and holidays and anything else they wish. Service users talked about all the activities they enjoy and take part in. Most have busy and interesting lives, going to various workshops, to college and/or have job placements during weekdays. They are all able to go out when they choose and have friends and family they meet up with regularly. The staff team are enthusiastic and are committed to the home and service users and work well together. New staff are checked to make sure they are suitable to care for people. Staff complete relevant training to help them keep service users’ safe and so that they understand and know how to support them better. The manager is experienced and qualified and runs the home well. There is an open management approach, which staff and service users value 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. King Street, 21a DS0000066942.V308299.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 King Street, 21a DS0000066942.V308299.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2&5 Quality in this outcome area is good. This judgement has been made using available evidence, including these visits to the service. The home is full currently but thorough assessment and admission procedures are in place to ensure that prospective service users needs would be suitably met by the home, should a vacancy arise. Current service users have agreed an appropriate contract with Aspire Living, in respect of the service provided. EVIDENCE: Service users had received their own copy of Aspire Living’s statement of terms & conditions. This document had been fully explained to them, before being agreed and signed by each service user and the manager. It sets out the rights and responsibilities of both parties, details of the charge and any additional costs, notice periods, the support, care and facilities offered, rules, rooms available and arrangements specified in care plans and for their review. The home has a policy & procedures for the assessment and admission of new service users, which the manager confirmed would be followed. This includes a full assessment made of their needs, introductory visits to the home and a trial period arranged. This process would involve the prospective service user, their family and relevant other people and a review would be held at the end of the trial before a decision made about the placement continuing. Aspire have produced a format for a service users’ guide and the manager plans to produce one for King Street soon, and should do so at once if a vacancy occurs. King Street, 21a DS0000066942.V308299.R01.S.doc Version 5.2 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in this outcome area is adequate. This judgement has been made using available evidence, including these visits to the service. Although staff know and understand service users’ needs and the support they need to meet them, most service users’ plans and risk assessments needed to be reviewed and updated so that they reflect their current needs and goals. Service users are able to make choices and decisions in their daily lives and routines. They are encouraged by staff to develop their social and life skills to promote their independence and their integration within the wider community. EVIDENCE: Two service users’ care records were looked at and care planning discussed with the manager and staff. Aspire Living have adopted an appropriate person centred approach to care planning. This involves service users assessing their own needs and drawing up a plan with staff, based on their wishes and goals. Staff have started to implement this system, however one person’s plan was drawn up in 2003 and whilst their needs had not changed a great deal it had not been reviewed and updated since. The other person’s plan is in the process of being revised and transferred to a person centred format called “My Plan”. King Street, 21a DS0000066942.V308299.R01.S.doc Version 5.2 Page 10 This plan covers all relevant areas of care needs and will include information about each service user’s family, friends, background and health. Plans need to be developed with the individual service user and describe their current needs, their aims and any action and support identified as needed to meet their personal goals. Possible risks to their safety will also be considered and an assessment carried about how the risks will be managed as part of the plan. Review meetings are currently being arranged to develop person centred plans for each service user, when their family and other significant people in their lives are appropriately invited to take part in this process if they want them to. Whilst service users must have a current written plan that is regularly reviewed it is clear from discussion with staff and service users that their diverse and individual needs are being recognised and appropriate support offered. The manager described how one personal care and gender issue is managed by staff and how this will be part of the service user’s revised risk assessment. Staff are now allocated to particular service users (chosen by them) as their keyworker. They offer them individual support and time so they can build up a closer relationship to enable them to understand and know their needs and wishes better. Keyworkers aim to arrange individual meetings monthly to give service users an opportunity to express their views and whether there is any thing they wish to do or to go etc. These discussions are recorded with details of any action needed and one service user said he finds these meetings very helpful and keeps his own copy of minutes. Keyworkers are also appropriately taking a lead role in reviewing and developing service users’ plans. Service users are clearly very self-determining and confirmed they choose their daily routines and life styles to a great extent. They also take responsibility and share most household tasks and cooking. House meetings are held weekly when service users choose their weekly meals and discuss general issues about the home, such as menus, activities, holidays and laundry rotas. Some service users are also actively in a local advocacy group, involving regular meetings, producing a news letter and a Bill of Rights for people with learning disabilities. King Street, 21a DS0000066942.V308299.R01.S.doc Version 5.2 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence, including these visits to the service. Service users lead full and interesting lives, pursuing a variety of activities they have chosen in the community. Their friendships and family relationships are supported by staff and their self-determination and individuality is respected. Food provided by the home is healthy and service users choose and help to plan and prepare their meals. EVIDENCE: Service users and staff discussed how service users continue to lead busy lives, as per their interests and wishes. Most attend day services, workshops, are involved in community projects and/or have work placements during the week. Those people without specific activities spent their time out with friends or in town. They are all able to go out in the local community without staff support and enjoy a variety of leisure activities, such as social clubs for people with learning disabilities, involvement with the Church and going to cafes and pubs. Whilst at home they pursue their own interests and hobbies including King Street, 21a DS0000066942.V308299.R01.S.doc Version 5.2 Page 12 listening to music, newspapers, watching television and using a computer. They had either been away this year or were to go on holiday with staff soon. Service users are fully involved in running the household, sharing the cleaning and cooking, doing their own laundry etc. They said they make decisions in their daily lives and routines, such as when to go to bed and where they go and those able to manage their own personal allowance. They choose their keyworkers are and are also involved in staff selection. Service users discussed contact with their relatives, most visiting, meeting up or staying with them regularly. They have friendships within and outside the home and socials are arranged a few times a year when they are all invited. Each service user has a birthday meal of their choice, when they invite guests. A record of food provided is kept as required for the main meal of the day and indicates that service users receive a variety of nutritious meals. Most meals are traditional with meat and fresh vegetables, although rice and pasta dishes are included. Staff said they make sure most meals are prepared with fresh ingredients, rather than by using convenience foods. One person’s special diet was fully understood by them and staff and together they ensure they have suitable meals and that their food intake and health is closely monitored. Service users help themselves to breakfast and either have lunch out, make themselves snacks or prepare and take out a packed lunch. Food stocks seen (and service users) confirmed that plenty of wholesome food is available for them to choose, such as yoghurts, fresh fruit and juice. Service users decide on and plan a weekly menu and take turns to cook the evening meal with staff support. Some of them also help with food shopping, and it is good all meat and fresh food/vegetables are purchased locally as they are needed. Service users said they like the food and enjoy all sitting together with staff for meals. King Street, 21a DS0000066942.V308299.R01.S.doc Version 5.2 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence, including these visits to the service. Service users are supported to meet their personal care needs and staff ensure they access appropriate health care input. It would confirm all service users’ health needs are being monitored, preventative steps taken and their good health promoted, if they have an individual Health Action Plan. Staff manage medicines safely in the home and support service users with their medication. EVIDENCE: Service users are mostly independent in respect of their personal care and hygiene, although staff assist and give them guidance as needed, as shown in their individual daily records. Records are also kept when they receive health care advice or treatment, including routine check ups and from specialists. There are individual procedures in place for people with specific health issues (i.e. epilepsy & diabetes) with some records kept by service users themselves. In the last inspection it was noted that service users’ health care needs had all been re-assessed and input sought from relevant health care professionals e.g. for continence management, communication and speech therapy. Keyworkers now take responsibility for making sure service users are supported to arrange routine health care checks, such as the dentist, optician and chiropodist. King Street, 21a DS0000066942.V308299.R01.S.doc Version 5.2 Page 14 It is considered good practice by the Department of Health for people with learning disabilities to each have a Health Action Plan. These plans can help to make sure that their health is closely monitored, any problems identified and that their good health is promoted. This would include that all their special health care needs are understood and recognised and they are helped to stay healthy through preventative as well as routine and specialist health care input Regarding the management of medicines in the home there are appropriate policies and procedures provided for staff and relevant guidance available from the Royal Pharmaceutical Society. Assessments had been carried out for some service users who self medicate and suitable lockable storage is provided for them. Service users discussed how they managed their own medicines and were knowledgeable and understood their particular health problem. Records relating to medicines kept and administered in the home were checked and being maintained appropriately. All staff had undertaken safe handling of medicines training as required. It was advised the home should obtain a recent copy of a British National Formulary of medicines for staff reference. King Street, 21a DS0000066942.V308299.R01.S.doc Version 5.2 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence, including these visits to the service. Service users feel able to express their views and any concerns and the home responds appropriately to any complaints and makes sure they are protected. EVIDENCE: Aspire provides a suitable written complaints procedure. Service users confirm they understand and have a copy of this document. They feel able to discuss any problems with staff and the manager and are confident they will be dealt with. It was observed service users are very comfortable with staff and they have an inclusive and respectful relationship. During these visits service users came in and out of the office to join in the discussions or offer to make drinks. There have not been any complaints or vulnerable adults concerns brought to the attention of the Commission or Social Services about the home. Only one complaint had been raised with the home since the last inspection, which the manager had discussed with the lead inspector and was resolved appropriately. It is advised a record of all issues or concerns raised by service users should be kept, with details of any investigation, the action taken and the outcome. There are policies & procedures in place relating to abuse and the protection of vulnerable adults, including whistle blowing. Most staff had received instruction from the Herefordshire Adult Protection co-ordinator including the multi-agency procedures for Protection of Vulnerable Adults. This ensures they know how and where to refer any suspicion or incidence of abuse or neglect of service users outside the home if necessary. The manager and staff interviewed are aware of and understand their responsibility to protect the service users. King Street, 21a DS0000066942.V308299.R01.S.doc Version 5.2 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is good. This judgement has been made using available evidence, including these visits to the service. Service users benefit from accommodation that suitably meets their needs and offers them a pleasant and comfortable home. Appropriate arrangements are in place to ensure the premises are kept safe, clean and in a good condition. EVIDENCE: 21A King Street is conveniently located in the centre of Hereford city. Service users appreciate this, as it is so close to the shops and other services and facilities. Especially as they are physically able and able to go out without staff support. The house has a good-sized lounge and a separate dining room with some armchairs, one bathroom, two shower rooms, four WCs and a small enclosed garden for everyone to use. Service users can also use the sitting room on the second floor to meet with staff and hold their care reviews etc. Service users all have single bedrooms, which do not have en-suite facilities. Four bedrooms have under 10sq metres of space, which has been accepted in the standards for pre-existing care homes, although they are rather small. The bedroom sizes are appropriately detailed in the home’s information documents. King Street, 21a DS0000066942.V308299.R01.S.doc Version 5.2 Page 17 Some service users acknowledge there is limited room for their possessions and clothes but are happy living at King Street and so have accepted this. The premises are maintained to a good standard and as the property is leased there is a management arrangement in place relating to ongoing maintenance and upgrading. Most responsibility does not actually lie with Aspire and as part of the transfer process a survey was carried out and a programme drawn up for any repairs and improvement needed. Since the last inspection, and as this programme specified, most of the house has been redecorated, new carpets have been fitted in sitting rooms, one bath renewed and another bath replaced with shower facilities. Service users had chosen the colours in their bedrooms and are pleased with them and the home looks brighter and fresher. The house was found to be warm, fresh, clean and tidy. Two service users said in their surveys however that the home is usually clean. The manager has recognised that some service users may need more support to keep their rooms and the communal areas clean. Staff are now working on this with them, through discussion in the house and their keyworker meetings. It was confirmed that staff have received appropriate training and there are policies & procedures to ensure good hygiene and infection control. King Street, 21a DS0000066942.V308299.R01.S.doc Version 5.2 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33 & 35 Quality in this outcome area is good. This judgement has been made using available evidence, including these visits to the service. Service users receive the support they each need from a committed staff team who are suitably trained and supervised and work well together. Thorough recruitment procedures help to make sure that only suitable people are employed to work in the home, for the protection of service users. EVIDENCE: Staff rotas show there is always one member of staff on waking duty between 7.00am & 11.00pm and one of them sleeps in at night on call. The manager mostly works weekdays, usually having one day a week and some time in the day when service users are out for administration. Staff and service users consider this as sufficient support to meet service users’ needs, although the manager sometimes covers care duties so limiting time for management tasks. The home is currently fully staffed, although the staff team is small comprising of the manager and five support workers. Occasionally agency staff have been deployed recently to cover the home, and whilst the manager has been happy with their actual input this is not really good for consistency of care and so the manager is currently reviewing the staffing situation with Aspire. King Street, 21a DS0000066942.V308299.R01.S.doc Version 5.2 Page 19 Staff interviewed clearly understand their responsibilities and are committed to their role as keyworkers to promote service users’ independence, monitor their welfare, support them as necessary and review their needs. They discussed their previous experience and qualifications and how they are able to use their skills and knowledge to help service users develop their life and social skills. One fairly new support worker discussed their recruitment, which appropriately included them completing an application form and attending an interview, when they met with service users. A police check and two written references had also been taken up before they started a three-month probationary period. The manager described Aspire’s recruitment procedures, which confirms that satisfactory processes are followed. Staff recruitment records could not be cross-checked however, as they are not kept at the home but held centrally by Aspire. It is recommended if it is not feasible for records to be kept on site for inspection that a checklist be kept in the home for staff. This checklist must confirm that satisfactory checks have been received (including an application form with a full employment history) which the registered provider or manager has verified. There should also be details of each staff member’s starting date, role and contracted hours with other relevant documents. (Reference Schedule 4 paragraph 6d, e, and g of the Care Home Regulations). The staff member interviewed felt they had a thorough induction to the home, which had included time spent with the manager and shadow shifts with staff. They were soon to start the LDAF induction programme, which the NMS specify new staff should take and is accredited especially for people working in care with people who have learning disabilities. Once they have completed their induction they hope to go on to enrol on an NVQ qualification in care. The pre-inspection questionnaire states staff had all undertaken the mandatory health & safety training, although records in the home show some refreshers were identified as needed and had been arranged. Staff interviewed confirmed their training and that they have also attended training sessions relating to care and service users’ needs, such as person centred planning, epilepsy and Makaton (a form of sign language). A record is kept on the home’s computer of the staff team’s training, which can be updated and shows when updates are needed. Each staff member also has an individual training record, with a supervision contract and records taken at supervision sessions, when their work performance and any training needs are discussed with the manager and signed by both parties. Staff also have an annual appraisal. Staff confirmed they feel well supported and are given an opportunity to express their views in supervision sessions and staff meetings. King Street, 21a DS0000066942.V308299.R01.S.doc Version 5.2 Page 20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39 & 42 Quality in this outcome area is good. This judgement has been made using available evidence, including these visits to the service. The home is well run by a competent and experienced manager and there is an open and positive management and staff team approach. This ensures service users’ individual rights are respected and that they receive a good service. When a formal quality assurance system is fully implemented it will ensure the service continually develops, as service users want it to and for their benefit. Appropriate steps are being taken (in line with relevant guidelines, law, policies & procedures) to keep the home safe and protect service users and staff. EVIDENCE: The manager (Mrs Liz Watkins) is suitably experienced and qualified, having worked for seventeen years with people with learning disabilities. Mrs Watkins has been a registered care manager since 2002 and has an NVQ 4 qualification in care and management as well as undertaken much other relevant training. King Street, 21a DS0000066942.V308299.R01.S.doc Version 5.2 Page 21 It was observed that the manager, staff and service users have an open and positive relationship and there is clear leadership in the way the home is being managed. Staff confirmed staff meetings are held monthly, they are kept well informed, the manager is approachable and they feel that their input is valued. Communication is good within the staff team, which detailed daily records kept by staff, shift handovers, and a communication book facilitate. Progress has been made to implement a formal quality assurance & monitoring system, which is linked in with the National Minimum Standards. The manager has received training and all relevant aspects of the service’s management will be reviewed and their effectiveness monitored and evaluated resulting in an action plan with timescales. Aspire has been working on producing a service users’ involvement policy, which will fully involve service users’ in all aspects of how the home is being run. Other stakeholders will also be involved and their views sought. The manager said the portfolio of evidence would have been collated within six months and then an annual development will be produced. Aspire Living provide a full range of policies & procedures for staff that are relevant to care service provision. They are currently being reviewed centrally and would all be updated in due course. Staff have been working their way through them and are able to freely access them. Regarding the health & safety of the premises, Environmental Heath and the Fire Authority inspected the home earlier this year when the provider changed. It was confirmed all their recommendations had been implemented. The manager states in the pre-inspection questionnaire that gas and central heating installations are serviced regularly and COSHH risk assessments are in place. The fire log was checked and showed all the required tests and checks recorded as having been undertaken at the specified intervals. Also fire drills are being arranged regularly with service users involved. Accident records are maintained appropriately and risk assessments carried out when necessary. There were no safely hazards identified during these visits and the evidence overall indicates that due attention is paid to promote heath and safety in the home to protect and promote the welfare of service users and staff. King Street, 21a DS0000066942.V308299.R01.S.doc Version 5.2 Page 22 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 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 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 X 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 1 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 3 3 2 X X 3 X King Street, 21a DS0000066942.V308299.R01.S.doc Version 5.2 Page 23 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 meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider must comply with the given timescales. No. Standard Regulation Requirement Timescale for action 1 YA6 15 Service users’ individual plans 31/01/07 must be reviewed and updated so they reflect all their current care needs and personal goals. 2 YA39 24 The provider must implement an 31/03/07 effective quality assurance and quality monitoring system. Progress has been made to produce and implement a formal quality assurance & monitoring system. Therefore the previous timescale of 31/07/06 is extended. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider to consider carrying out. No. Refer to Good Practice Recommendations Standard 1 YA19 Health Action Plans should be set up for service users to help them stay healthy. 2 YA22 A record should be kept of all issues raised or complaints made by service users, with details of any investigation, action and outcomes. This record to be checked at least three monthly. 3 YA34 A checklist should be kept in the home for all staff confirming the conditions of their employment and that satisfactory checks etc were received before their appointment was confirmed. The details to have been checked and verified by the registered manager or provider. King Street, 21a DS0000066942.V308299.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Worcester Local Office Commission for Social Care Inspection The Coach House John Comyn Drive Perdiswell Park, Droitwich Road Worcester WR3 7NW National Enquiry Line: 0845 015 0120 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 King Street, 21a DS0000066942.V308299.R01.S.doc Version 5.2 Page 25 - 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. 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