Inspection on 05/06/07 for 23 Valley Road

This inspection was carried out on 5th 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

23 Valley Road 03/06/08

Similar services:

Kestrel House, St Anne`s Opportunity Centre,

Pinta

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

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

CARE HOME ADULTS 18-65 23 Valley Road 23 Valley Road Totton Southampton SO24 9FP Lead Inspector Tim Inkson Unannounced Inspection 5th June 2007 09:30 DS0000068949.V339707.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 DS0000068949.V339707.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. DS0000068949.V339707.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 23 Valley Road Address 23 Valley Road Totton Southampton SO24 9FP 01420 542447 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) People Potential (UK) Ltd Stewart Charles Akass Care Home 4 Category(ies) of Learning disability (4) registration, with number of places DS0000068949.V339707.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection N/A Brief Description of the Service: 23 Valley Road is detached family house located in an estate with mixed properties on the edge of the town of Totton and some 7 miles west of the city Southampton. Local amenities consist of those that can be expected in any reasonable sized town and access to public transport is good. The use of the building as a care home is not obvious and it is domestic in scale. It is registered to accommodate and provide personal care and support for up to 4 people between the ages of 18 and 65 with learning disabilities. It has bedroom accommodation is on two floors with three on the first floor and one on the ground. Three of the bedrooms have en-suite facilities comprising either a bath or a shower and the fourth has a bathroom situated immediately across a small landing. There is a large communal lounge and separate dining room on the ground floor as well as a communal WC, utility room and large kitchen. To the rear of a building is a sizeable secluded garden and at the front there is space for two cars outside the integral garage and a small area of garden. All people intending to live in the home move in through care management arrangements with the support of a social worker/care manager and usually also involving other interested persons i.e. relatives. Information about the service that the home provides is made available during the moving in process that is carefully planned. Individuals are provided with a personal “welcome pack” telling them about the service the home provides before they move in that is produced in language format suitable for that person e.g. symbols and pictures. At the time of a site to the home on 5th June 2007 the fees ranged from approximately £1500 to £2000 a week depending on the level of support that the individual concerned required. This did not include toiletries, newspapers and magazines; confectionary; hairdressing; podiatry; and the entrance fee to places of interest/entertainment DS0000068949.V339707.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This site visit was part of the process of the first key inspection of the home that was registered in December 2006 and began operating in January 2007. It was unannounced and took place on 5th June 2007, starting at 08:50 and finishing at 14:50 hours. During the visit accommodation was viewed including bedrooms, communal/shared areas and the home’s kitchen and laundry. Documents and records were examined and staff working practice was observed where this was possible without being intrusive. People living in the home and staff were spoken to in order to obtain their perceptions of the service that the home provided. At the time of the inspection the home was accommodating 2 people, both were male and their ages were 19 and 22 years, neither was from a minority ethnic group. The home’s registered manager was present during most of the visit and was available to provide assistance and information when required. The relatives of and care managers for the people living in the home were canvassed for their views about the home using questionnaires, before the site visit took place. Their responses (3) were taken into consideration when producing this report. Other matters that influenced this report included: An Annual Quality Assurance Assessment completed by the registered manager in which he set out how he believed the home met and planned to exceed the National Minimum Standards (NMS) for Care Homes for Adults (18 –65) and evidence to support this. A “dataset” containing information about the home’s staff team, and some of its managements systems and procedures. Information that the Commission for Social Care inspection had received such as statutory notices about incidents/accidents that had occurred. What the service does well: There was detailed written information about the needs of the people that lived that enabled the staff to provide the help and support that each individual required. The home promoted equality and diversity and its routines were flexible. Individuals were encouraged and supported to make choices for themselves and use the amenities in the local community. The building was spacious, comfortable, well furnished and decorated. Confidence in the home’s management was expressed by relatives of people living in the home and social care professionals. There was a strong commitment to staff support, training and development to ensure that they were able to fulfil their roles and responsibilities and meet the complex and diverse needs of people living in the home. DS0000068949.V339707.R01.S.doc Version 5.2 Page 6 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. DS0000068949.V339707.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 DS0000068949.V339707.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. The home had systems and procedure in place to enable people that intend to live there to make an informed choice about whether to do so. The help that they needed was identified before they moved in to ensure that the home could properly provide it. People living in the home would benefit from having details provided to them about their rights and obligations in a format suitable to their individual needs. EVIDENCE: The records were examined of the 2 people living in the home at the time of the site visit. It was apparent from them and comments from relatives that were canvassed, that the individuals concerned had both been provided with some information about the home before they moved in. A welcome pack that was produced in a format suitable/personalised for the individual concerned had been provided to them. In questionnaires returned by relatives whose views were canvassed about the home, 100 thought they had sufficient information to enable them to make a decision about whether their relative should live in the home. It was also clear from the documents seen and the comments of relatives and a social care professional that the level and type of support that individuals required was identified in great detail before they moved in. It was obtained by senior staff working for the company that owned the home who had the necessary knowledge and expertise i.e. the head of care. There was a “transition” period as part of the process of moving into the home that in the case of one person included staff that would be working with the DS0000068949.V339707.R01.S.doc Version 5.2 Page 9 individual when they moved visiting them where they were living. Also the individual concerned visited the home and if it was part of the agreed plan stayed for a day or two before they made the final decision to move in. • “I have been impressed with my son’s key worker and so have XX College that have been involved in the transition process”. • “They provide support and assistance when going through the application process. They appear to match key workers to clients well and provided a very comprehensive assessment report. They have been very accommodating to make both J and ourselves welcome at any time we request”. The staff group working in the home had a full week’s induction training as a group before the home began operating in January 2007. Most of them had worked for another organisation providing services for young adults with learning disabilities and moved to the company that owned the home and then the home itself just before it opened. They all had relevant experience and their induction and subsequent regular training was in subjects that were relevant to the type of support required and about the needs of individuals living in the home e.g. autistic spectrum disorder, epilepsy. The comments from a social care professional whose views were canvassed inclued: • “Staff I have met have appropriate skills and experience and are enthusiastic The home’s policies and procedures referred to the principles set out in a government white paper “Valuing People” that was concerned with improving services and opportunities for people with learning disabilities and its key principles of: Rights; Independence; Inclusion; and Choice The home also based its philosophy/ethos on O’Brien’s accomplishments i.e. Community presence; Community participation; Choice; Respect/status; and Competencies. The individuals living in the home had not been given licence agreements setting out their terms of occupancy. However as all individuals moved into the home through care management arrangements the home had formal contracts for each person living in the home with their respective sponsoring/funding local authority. Also relatives and carers that were supporting a person before they moved into the home were provided with a copy of the home’s service users guide in order that they could explain to the person moving into the home all the rights obligations set out in the home’s terms and conditions of accommodation/licence agreement. The company that owned the home were working on producing a service users guides and licence agreements in different formats to suit the needs of individuals that they accommodated. They were intending to have them ready by the end of June 2007. DS0000068949.V339707.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, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in the home were involved in planning the care and support that they received and risks they took and were able to exercise choices about dayto-day life in the home. Sensitive information about them was looked after properly. EVIDENCE: The documents examined during the site visit included comprehensive plans setting out details of the support that each person living in the home needed and how it was to be provided. The home was working on producing the plans in formats suitable for the individual concerned based on a model called “My Life” using pictures and diagrams. The plans were focussed on the choices and wishes of the individual indicating that “person centred planning” was the principle upon which they were based. They also included instructions for staff to follow that ensured that the person’s dignity was promoted e.g. “Before going out in the community N should be properly dressed and equipped for particular situation”. DS0000068949.V339707.R01.S.doc Version 5.2 Page 11 Each care plan included risk assessments that identified possible harm to the individual but the home also recognised that some risk taking can have benefits and result in a better quality of life. There was evidence that care plans were reviewed regularly. Where an individuals right to make decisions was limited this had normally been agreed with that person and the decision recorded, with one exception. This was discussed with the registered manager who said that it would be addressed without delay. During the visit it was noted that staff discussed decisions and choices with people living in the home about a range of matters, such as activities they wished to pursue and food to be eaten. The registered manager said that the company that owned the home were looking into ways of including people living in the home in the interviewing/appointment of new staff. The home had policies and procedures about confidentiality and sensitive information about individuals living in the home was kept securely in the staff office. DS0000068949.V339707.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 good. This judgement has been made using available evidence including a visit to this service. The home promoted the right of people living in the home to live ordinary and meaningful lives. They were supported to take part in social, educational and recreational activities and to develop life skills. EVIDENCE: One of the people living in the home had enrolled on a course in “life skills” one day a week at a local college. On the morning of the site visit he attended the course and on his return indicated that he had enjoyed himself and wanted in future to go more than once a week. Care plans examined indicated that several areas of self-development had been identified for individuals and there were some specific objectives identified and being worked with i.e. healthy eating and understanding money. During the visit it was noted that staff were working with individuals and reinforcing these particular issues through everyday activities. Other plans referred to developing particular skills to be used in specific situations e.g. to develop appropriate social skills by example, opportunity and DS0000068949.V339707.R01.S.doc Version 5.2 Page 13 guidance i.e. to shake hands where appropriate as a form of greeting; to use toilet appropriately and avoid social stigma through soiling. People living in the home spoken to indicated that they were able to use recreational facilities in the local community as well as pursue their chosen pastimes and leisure activities. • “We go to the Pyramids (a swimming pool) … I watch TV in the lounge and sometimes in my room. I like cartoons … I like my play-station”. It was apparent from records kept by the home that regular outing were arranged to places of interest and where the people living in the home could participate in activities they enjoyed e.g. canoeing at a country park and visits to a beach. Relatives and people living in the home indicated that the home promoted the right of individuals to maintain contact with their families and friends. • “I see my Mum, I go and see her and she comes here”. The home’s registered manager described the routines in the home as relaxed and said, “The rhythms of the home dictate the routines they are not at all rigid, there are of course elements of structure but it is individually focussed”. One of the people living in the home was up and having breakfast at the time the site visit started at 08:35 because he was going to a local college, but the day for the other person living in the home was more leisurely and he got up later and went out shopping for food he required because of his dietary needs. One of the individuals said, “If I don’t go to college I can stay in bed”. The home promoted healthy eating and also had to cater for the very specific dietary requirements of one individual. There were large colourful posters on display in the kitchen and guidance about diet. Information about the likes, dislikes and dietary requirements of people living in the home was readily available in the kitchen. Records indicated that a range and choice of meals was provided and individuals spoken to said that they were involved in choosing the menus and preparing the meals. • The food is good and I do some of the cooking. I tell them what I want and I have Chinese food. I take sandwiches to college. I had boiled eggs for breakfast sometimes I have cereal Staff were noted supporting one individual choose and prepare his packed lunch. Detailed records were kept of the food consumed by individuals in a “weekly diet and nutrition diary”. Records were also kept of individuals’ weight. Relatives appreciated the steps that the home was taking promoting healthy eating. DS0000068949.V339707.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health and personal care that people received was based on their individual needs and their medication was managed safely. EVIDENCE: The care plans examined set out in detail how the help and support an individual needed was to be provided. Staff spoken to were able to describe the needs of the individuals in the home and how they were met in accordance with the plans. Staff were required to sign a care plans awareness document to indicate that they had read them and understood their contents. The home had made referrals to specialist healthcare professionals in order to obtain support and advice about the specific needs of individuals. There was evidence in records of correspondence with relevant specialists about the use and level of certain medication for one person. The gender of staff providing help was discussed with the home’s registered manager and he said that if it were ever a contentious issue then the home would respond appropriately. People living in the home were supported to use local medical services and visit them for appointments as required. One individual said, “I have seen a doctor”. A social care profesional who was canvassed for perceptions about the home said the following about these matters, “… they have been vigilant in addressing needs … reporting issues and referring appropriately”. DS0000068949.V339707.R01.S.doc Version 5.2 Page 15 The home kept a record and spreadsheet of episodes of epilepsy had by an individual and also used a sound monitor in his room at night in order to alert night staff if he had a seizure. The potential for this to undermine the individual’s privacy was acknowledged and there were instructions in place that it must be turned off during the day. The home had written policies and procedures about the management of medication. These were however generic and not specifically about the actual practice in the home. The home’s registered manager said that he would produce amended and home specific procedures without delay. Medicines were kept in a suitable locked metal cabinet and the home used a monitored dosage system with most prescribed medicines put into blister packs for a period of 28 days by a pharmacist. The exception being those that could not such as liquids or items that would deteriorate when removed from their containers. Records were kept of the receipt into the home of medicines, giving out and disposal of unwanted items and all were accurate and up to date. There was some discussion about the use of medication for one individual that was to be given only on occasions that it was required (PRN) and the instructions on the medication administration chart said it was to be given “when agitated”. The individuals plan of care plan however included very clear criteria about when this should be given and staff spoken to about this said, “We don’t make that decision on our own, we contact the manager or doctor or we try to divert attention by taking him out for a drive or something”. Staff had or were undertaking training through a local college in “safe handling of medication” and all had received some training in understanding medicines as part of the “common induction standards” training they did or were doing after they started working in the home. One good practice matter that was noted was the sample signatures of the staff that gave out medication. The home had a written policy and procedures about “Supporting terminally ill service users”. DS0000068949.V339707.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in the home had access to a complaints procedure that would enable the home to address their concerns. There was a system in place in the home to protect vulnerable adults from harm. EVIDENCE: The home had a written complaints procedure but at the time of the site visit there was no alternative version readily available with pictures or symbols for individuals to refer to who might be unable to read or to communicate verbally. A representative from the company that owned the home said that the matter was being addressed without delay to ensure that individuals were provided with a copy of the procedure in a format suitable for them. The home’s registered manager was spoken to about several matters 2 days after the site visit and said that a poster using pictures and symbols to explain the complaints procedure had been put on display in the home. The home had a system for keeping records of complaints and had received none since it started operating in January 2007. “The Commission” had received no complaints about the home during the same period. There were written procedures readily available in the home for the guidance of staff, about safeguarding vulnerable adults. These included a copy of the local authority’s adult protection procedures. Staff had received training in the subject of adult protection and those spoken to knew what to do if they suspected or knew that it had occurred. The home had made 2 referrals to the local authority under their adult protection procedures and the home’s registered manager had been proactive in notifying the relevant authorities/agencies about matters of concern. DS0000068949.V339707.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. The home’s environment was comfortable safe, and well-maintained for the benefit of the people living and working in it. EVIDENCE: At the time of the visit the exterior and interior of the home was in good decorative order and its furnishings and fittings were in good repair. The premises were clean and hygienic and there was evidence that there were systems in place to ensure a regular and routine cleaning schedule was implemented. During the visit a person with maintenance responsibilities was seen repairing a door handle that had been damaged by one of the people living in the home. The accommodation was domestic in nature and scale and bedrooms were spacious and 3 of the 4 had en-suite WCs and either a bath or shower the other had its own bathroom located across a small landing. Occupied bedrooms viewed during a tour of the premises had been personalised for or by the individual concerned and they were able to decide on their own colour scheme in their bedrooms. One individual spoken to said, “I Like my bedroom”. DS0000068949.V339707.R01.S.doc Version 5.2 Page 18 Communal space was on the ground floor and comprised a large and separate dining room, large kitchen a WC and a utility. There was a good-sized secluded rear garden. All windows in the home were fitted with restrictor, hot water outlets were fitted with thermostatic controls to ensure that it was delivered at a safe temperature to prevent scalding and guards had been installed on all radiators. The utility room was clean and tidy and equipped with modern washing that had a sluice programme and there was an appropriate system in place for managing any soiled linen. There were no adaptations, fittings or equipment in place for individuals who may have a physical disability. The home’s registered manager stressed that should and this be identified at the assessment stage of the process of someone preparing to move into the home the necessary work would be carried out for that person. Similarly that the occupational therapy services of the local authority would be involved if someone’s needs changed and they required equipment such as a raised WC seat or handrails. There was signage i.e. symbols in the kitchen on cupboards and containers and also on furniture in the rooms of people living in the home to indicate what the contents were. Comments from relatives and a social care professional whose views were canvassed about the premises included: • “They have thought about the users of their services when refurbishing/building and tailored it accordingly”. • “The quality of physical environment is good”. DS0000068949.V339707.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 recruitment, training, support for, deployment level and skill mix of staff ensured the complex needs of people living in the home were met and their safety was promoted. EVIDENCE: At the time of the site visit the level of staff on duty was in accordance with the its published rota i.e. 07:30 to 15:00 15:00 to 22:00 Waking night 21:30 to 08:00 2 2 1 The home’s registered was manager was supernumerary and he said that extra staff would be deployed to ensure that people living in the home could take part in different activities and pursue their individual leisure pursuits. The staff group was based on 3 teams comprising a senior support worker and support worker/facilitator. There was also support for the home and its staff group available from senior staff on call and a central office team that comprised: • Head of care/clinical support • Personnel manager DS0000068949.V339707.R01.S.doc Version 5.2 Page 20 • Training and quality manager • Maintenance person At the time of the visit the home employed 5 care staff and of these 1 (i.e. 20 ) had an appropriate National Vocational Qualification (NVQ) at level 2 and the home’s registered manager said that another was being recruited with the qualification. It was also still recruiting staff and working towards its full staffing complement because it had only been operating since January 2007 and it was not fully occupied. Consequently agency staff were used to provide cover on some shifts and the home endeavoured to ensure consistency by attempting to use the same agency and have them provide the same staff as often as possible. One member of staff described working in the home and the level of staffing: • “The staffing level is good and we never have less than 2 on duty on a shift. There is a nice atmosphere here and a really good staff team”. Staff spoken to described the training that they had attended that enabled them to understand and work with the complex needs and behaviours of the people living in the home including e.g. autistic spectrum disorder; epilepsy; and physical intervention. They also said that regular staff meetings were held in the home and that they received regular supervision. Records examined confirmed the content of the conversations with staff. There was also evidence from discussion and records examined that there was there was structured staff induction training that complied with the expectations of the social care workforce development body, “Skills for Care”, common induction standards. Every member of staff attended a paid training day and this was made possible by a training programme that repeated itself to enable all staff to attend subjects considered essential Induction training included guidance on adult protection and dealing with violence toward staff, racial harassment and equal opportunities. Staff also completed training in first aid, health and safety, manual handling, fire safety, food hygiene, managing medicines and infection control. All staff had also undertaken accredited training in physical intervention i.e. Strategies for Crisis Intervention and Prevention Revised (SCIPR). Further training was planned in relevant topics such as person centred planning and the home’s registered manager said that the company that owned the home was applying to become an accredited NVQ training centre. Comments from staff spoken to about their training included: • “I have been working here since January. Before that I was a support worker working with young adults with special needs. My induction here was for a week and it included fire safety, health and safety, policies and procedures. We are continually learning and I am doing a medication course through Brockenhurst College, I have done epilepsy, food hygiene. I learnt about autism in my previous job. I have supervision every 2 months and have meetings with the head of care. We have staff meetings every month ... I am hoping to do NVQ”. DS0000068949.V339707.R01.S.doc Version 5.2 Page 21 • “ I have an NVQ level 2 – and I have discussed doing NVQ level 3 … I have done the common induction standards. In the training we cover autism, communication, confidentiality and basically all the policies and procedures. The training manager comes around and checks that we completed induction … I have done my SCIP R training and meds training 5 units”. The home had written policies and procedures about staff recruitment and it indicated that staff appointments were subject to satisfactory, Protection of Vulnerable Adult (POVA) and Enhanced Criminal Record Bureau (CRB) checks and 2 references and completion of a 3 month probationary period. The records of all the home’s permanent staff were examined. It was apparent that all the necessary pre-employment checks had been completed to ensure that anyone considered unsuitable to work with vulnerable adults was not employed. The home also obtained assurances and details from the agency that it used that it had obtained satisfactory enhanced CRB checks for staff supplied to the home. DS0000068949.V339707.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, 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’s registered manager provided effective leadership There were systems and procedures in place for monitoring and maintaining the quality of the service provided although this could be formalised and also for promoting the safety and welfare of everyone living and working in the home. EVIDENCE: The home’s registered manager had several years experience of working with young adults with a range of complex needs in supervisory and management positions before taking up the post of manager at this home. He also managed another care home also owned by the same company and located in the Southampton area. He completed and obtained a relevant management qualification i.e. the Registered managers Award in January 2007 and he said that he intended to work towards obtaining an NVQ level 4 in care later in the year. DS0000068949.V339707.R01.S.doc Version 5.2 Page 23 From discussion with the registered manager, and from observation and discussion with staff, people living in the home and comments from people whose views were canvassed about the management of the home. It was apparent that the registered manager was; organised; highly motivated; enthusiastic; sensitive to and understanding of the needs of both the home’s staff team and the individuals accommodated there. • “I find the manager’s approach suits me. I am able to make decisions. If you need to talk to him he is always available” (staff member). • “He is great. He will listen to your ideas and give a lot of support and is available on the phone even if he is not at work” ” (staff member). • • “Valley Road is outstanding at every level so far. I cannot praise them highly enough” (relative). “Managing behaviour – promoting self confidence, dignity and self respect – liaison with professionals- motivating client and encouraging progress – enabling to take part in community liaison with relatives – reporting problems appropriately - All that I have seen suggests good practice” (comments from a care manager about what the home managed well). The home was registered in December 2006 and only started operating in January 2007, consequently there was no formal or established quality monitoring system that took the views of people living in the home and other interested parties into account. Internal reviews of the service by a representative form the company that owned the home were carried out and comprised visits to the home at least monthly in order to comply with Regulation 26 of the Care Homes Regulations 2001. It was apparent from documents seen that had been produced following these visits that an action plan was developed clearly setting out what had to be done, by whom and when, in order to rectify any matters that were identified as requiring improvement during these visits. The home’s registered manager said that the company was looking into ways of including people living in the home in the interviewing/appointment of new staff. He also said that company had identified the need for a number of new/additional policies and procedures necessary for staff information and guidance e.g. Gifts to staff; Emergency Admission and Detention under the Mental Health Act 1983; Annual development plan for Quality Assurance; and moving and handling. The home had a range of policies and procedures available that were readily accessible to staff and informed their working practice. They included the following: • Supporting terminally ill service users • Recruitment • Physical intervention • Service users financial affairs • Intimate personal relationships and sexuality • Medication • Care planning DS0000068949.V339707.R01.S.doc Version 5.2 Page 24 • • • Admissions Accident reporting Health and safety One of the above clearly indicated the home’s approach to the promotion of equality and diversity. Extracts from in its policy about “Intimate Personal Relationships and Sexuality” included: “ … Seek to ensure proper balance between an individuals rights, their physical and emotional safety and the rights and responsibilities of others … right to have opportunities to love and be loved and to engage in consenting relationships whether sexual or not … staff need to understand the diversity of sexual expression and sexual preference and respect this … (there was also reference in the policy to appropriate training). All the statutorily required records that the home was keeping that were examined were accurate and up to date. Records seen and discussion with staff indicated that safe working practices were promoted in the home. Up to date certificates were on file concerned with gas safety and electrical wiring. Records and discussion also indicated that fire safety systems and equipment were checked and monitored and staff and people living in the home had received fire safety training. DS0000068949.V339707.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 2 2 3 3 3 4 3 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 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 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 3 X 3 3 3 3 X DS0000068949.V339707.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? N/A 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations DS0000068949.V339707.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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. 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