Inspection on 24/07/07 for Ormerod Home Trust

This inspection was carried out on 24th July 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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Ormerod Home Trust 12/12/05

Ormerod Home Trust 13/09/05

Ormerod Home Trust 24/09/04

Ormerod Home Trust 12/05/04

Ormerod Home Trust 14/12/03

Ormerod Home Trust 15/09/03

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

CARE HOME ADULTS 18-65 Ormerod Home Trust 35 Bromley Road St Annes Lancashire FY8 1PQ Lead Inspector Lesley Plant Unannounced Inspection 24 and 26th July 2007 2:30 th Ormerod Home Trust DS0000010017.V340476.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 Ormerod Home Trust DS0000010017.V340476.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. Ormerod Home Trust DS0000010017.V340476.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ormerod Home Trust Address 35 Bromley Road St Annes Lancashire FY8 1PQ 01253 723513 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) Ormerod Home Trust Limited Mr Victor William Murgatroyd Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Ormerod Home Trust DS0000010017.V340476.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. The service is registered to accommodate a maximum of 5 service users in the category LD (learning disability). 14th July 2006 Date of last inspection Brief Description of the Service: The service at Bromley Road is registered to provide support for five people with learning disabilities. The home is situated in a residential area of St Annes, close to the beach and shopping area. The amenities of the local community are within easy reach. The home is well served by public transport. The layout of the home would not be suitable for wheelchair users. The home is owned by Ormerod, a trust, which operates a number of residential and community based services in Lytham St Annes and the surrounding area. The home is guided by the policies and procedures of Ormerod, and has its own dedicated staff team. Ormerod Home Trust DS0000010017.V340476.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced, took place during two visits to the home and looked at the key national minimum standards, plus supervision arrangements for staff. At the time of the inspection there were five people living at the home. The inspector spoke to the registered manager; the senior support worker and one of the support workers working at Bromley Road. Records were viewed and a tour of the building took place. Time was spent observing staff and the people living at the home, engaged in daily activities. Information was gained from the Annual Quality Assurance Assessment completed by the registered manager and a visit to the organisation’s main office, also took place, where recruitment and training records were examined. Comment cards providing feedback were received from four health/social care professionals with links to the home and three relatives. Staff supported the five people living at the home to complete survey forms. What the service does well: Picture boards and photographs are used to aid communication and decisionmaking. These are proving particularly useful for one person who has dementia. The photos and labels clearly act as a prompt and help him to recognise and remember important information. The dining kitchen is big enough for people to watch meal preparation. The home also has two large living rooms, allowing space for people to choose to spend time alone or join in small group activities. Ormerod provides excellent opportunities for qualification training, which is highly valued by staff. NVQ training is strongly promoted and all the staff have now achieved NVQ level 2 or above. Staff appeared to be motivated and demonstrated good communication skills, assisting the inspector to communicate with the people living at the home. The atmosphere was relaxed and the relationships between staff and individuals living at the home appeared to be positive. Ormerod provides an excellent staff-training programme. Training is organised by a dedicated training team based at the main office. There is a rolling programme of core training, with dates being set for the year. Training is also arranged according to the specific needs of the people living at Bromley Road. The supervision and appraisal system is excellent, meaning that staff are well supported and guided in their work. Ormerod Home Trust DS0000010017.V340476.R01.S.doc Version 5.2 Page 6 The range of quality monitoring systems is excellent. There are internal and external quality monitoring systems in place. What has improved since the last inspection? What they could do better: Ormerod Home Trust DS0000010017.V340476.R01.S.doc Version 5.2 Page 7 Discussions with the registered manager confirmed that one to one support is now only available for one person living at the home and that increased funding for others is being pursued. More one to one time with staff would allow for increased community integration. A daily record sheet is completed in respect of each person living at the home and although some contain good information, some records are brief. The quantity and quality of the daily records could be improved. Much progress has been made with person centred planning at Bromley Road. This needs to be sustained, in order that the improvements can be built upon and be reflected in positive outcomes for the people living there. For one individual, there was no record of the reason or outcome of two health appointments recorded on the calendar. Records should be kept of all health care appointments, with detailed information regarding the reason and outcome. The provider organisation has produced specific health appointment record sheets, but these are not being consistently used at Bromley Road. The organisations’ health appointment record sheets would allow for easier tracking of any health practitioner input. The registered manager informed the inspector that there are plans for a Housing Association to buy the property and that this would then lead to an refurbishment of many areas of the home. As there is no definite timeframe for this change of ownership, the provider organisation must address some of the areas identified in this report. The repair/renewal of the radiator covers, re grouting of showers/bathrooms and the carpeting of one of the bedrooms would improve the home in the short term. Although water temperatures are thermostatically controlled, there should be some monitoring and recording of water temperatures at the home. 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. Ormerod Home Trust DS0000010017.V340476.R01.S.doc Version 5.2 Page 8 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 Ormerod Home Trust DS0000010017.V340476.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. Well established assessment and introductory processes ensure that needs are assessed and only suitable placements are made. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The provider organisation has well established processes in place, which ensure that thorough assessments are carried out before admitting new people to the home. The written policy regarding admission to the service includes the giving of information, the terms and conditions of residency and a set assessment format. Information about the home is produced in a pictorial format and complimented by written material. All introductions are planned and taken at a pace suitable to the individual. Relatives are involved as appropriate. Two people have been admitted to the home since the last inspection. Both individuals were already being supported by Ormerod and knew the other residents at Bromley Road. Risk assessments were reviewed and file information transferred to Bromley Road. A brief introductory period took place, which included a visit for tea, before these individuals moved into the home. A member of staff who worked with these two people at their previous Ormerod Home Trust DS0000010017.V340476.R01.S.doc Version 5.2 Page 10 residence joined the Bromley Road staff team, in order to provide continuity of care support. There are plans for the further changes, with the option of supported living being explored. The inspector was informed that these changes would take into account compatibility, and existing relationships within the group. There are plans for another person to move into the home, when a vacancy arises, and introductory visits are taking place, as observed during this inspection. Records are kept of these introductory visits. Ormerod Home Trust DS0000010017.V340476.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Quality in this outcome area is good. Care planning and person centred planning is now established, meaning that personal goals are identified and worked towards. Individuals are supported to make decisions. Risks are identified and action is taken to minimise these risks. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The care planning records for all five people living at the home were examined. Each person has an individual service plan, which details the practical support required for all aspects of day-to-day living. These care plans guide staff in their day-to-day work, are being reviewed every month and are particularly useful for new staff. Some people also have social work care plans in place. Ormerod also has a well-established system of person centred planning. Time is spent with the individual helping to identify goals and wishes for the future. Tools such as the ‘changing days’ booklet and ‘listen to me’ workbook are Ormerod Home Trust DS0000010017.V340476.R01.S.doc Version 5.2 Page 12 used. Pictures and photographs are used to aid this communication and to make the process meaningful to the person involved. Relatives are involved as appropriate. Key workers then complete monthly progress records to monitor progress towards achieving the goals identified. Since the last inspection, there have been improvements to the person centred planning carried out at Bromley Road. Person Centred Planning meetings take place at least every 12 months and goals are clearly identified, with progress being monitored. Records show that planning focuses on areas such as; what we like and admire about the person, what is important to the person, what we have learned, what the person needs to keep safe and healthy, last years goals and goals for the future. Staff have been working hard to monitor progress, which is recorded on a monthly/bi monthly progress sheet. In the main there is consistency with this monitoring, however for one person living at the home, there did not appear to be any monitoring of progress towards goals identified at a person centred planning meeting held in March. The senior support worker confirmed that this would be attended to. Relatives and other significant people are involved in person centred planning meetings, evidenced by copies of invitation letters held on files and records of the meetings held. Person Centred Planning meetings use pictures and photographs to celebrate achievements. A social care professional who has links with the home and completed a feedback questionnaire, commented; “The person centred review this year was lovely.” The progress made in this area needs to be sustained, in order that the improvements regarding person centred planning can be built upon and be reflected in positive outcomes for the people living at Bromley Road. Each person has a useful communication profile detailing how the individual expresses themselves and the interpretation of various personal nuances. Some of the team have undertaken specific communication training and communication is also explored during induction and NVQ programmes. Staff work closely alongside individuals and via this intimate day-to-day work, have got to know the people living at the home very well. Picture boards and photographs are used to aid communication and decision-making. These are proving particularly useful for one person who has dementia. On the first day of the inspection, this person readily took the inspector to the picture board and talked about what day it was, who would be helping him that day and other significant information. The photos and labels clearly act as a prompt and help him to remember important data. File recordings show that risks are identified and management strategies put in place. The senior support worker at the home regularly reviews the written risk assessments. The two new people living at the home, both had new risk assessments drawn up. Risk management plans address a range of issues Ormerod Home Trust DS0000010017.V340476.R01.S.doc Version 5.2 Page 13 including; approaching strangers, risks from traffic and potential risks from household cleaning materials. Ormerod Home Trust DS0000010017.V340476.R01.S.doc Version 5.2 Page 14 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 Quality in this outcome area is good. Activities are arranged according to people’s preferences and staff provide good support to ensure that family links are maintained. Individuals are supported to take part in household tasks. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is close to the centre of St Annes, giving easy access to a large range of community facilities. Person centred planning helps to identify and maintain existing interests and also encourages the exploration of new activities. The five people currently living at Bromley Road are engaged in a variety of activities; including activities arranged via the Ormerod resource centre. The resource centre oversees certain activities such as “Can Able”, a recycling service and “Spice up your Life”, a project whereby people prepare and bottle spices, chutney and preserves, to sell locally. One person has a cleaning job at a local hotel for just a few hours when needed. Activities Ormerod Home Trust DS0000010017.V340476.R01.S.doc Version 5.2 Page 15 supported by staff at the home, include playing crazy golf, horse riding, bowling and going to the library. One person was keen to show the inspector photographs from a recent activity type holiday, which he had clearly enjoyed and another explained how she liked to go to the library to borrow music discs. Ormerod provides a minibus and a car, which staff can book for the use of those living at Bromley Road. Staff rotas show that support is provided flexibly. A relative who completed a feedback questionnaire commented; “The home … offers support to do the extra things in life, which make it more exciting i.e. holidays, music concerts, pub visits etc.” A social care professional who completed a feedback comment card stated;” the service user known to me is a keen church goer and is a member of her local church, she attends social events and groups.” Discussions with the registered manager confirmed that one to one support is now only available for one person living at the home and that increased funding for others is being pursued. More one to one time with staff would allow for increased community integration. Staff work hard to support individuals to maintain relationships and family links. Records are kept of contact with relatives. Files contain photos and details of people important to the individual, with dates of birthdays. Ormerod provides training for staff regarding working with families and arranges family and friends events, when relatives are invited and are able to keep up to date with service developments. Relatives are also invited to person centred planning meetings. One person is supported to keep in touch with relatives who live overseas and this person explained that she had recently been supported to visit her pen pal, who lives in Yorkshire. During the inspection plans were being made to hold a birthday party for one person living at the home and staff confirmed that a close relative had been invited and would be attending. A relative who completed a feedback questionnaire commented; “usually ******’s (name of person) key worker rings us to let us know about any changes, if he is going on holiday, ill etc. They let us know relevant information, without invading ******’s privacy by telling us absolutely everything about him.” People are involved in household activities, according to their wishes and abilities. Individual responsibilities, such as carrying out personal laundry tasks are encouraged. Staff take on the main responsibility for cleaning and cooking, with individuals being encouraged to join in or watch. The communication between staff and those living at the home encourages participation, as observed during this inspection. The dining kitchen is big enough for people to watch meal preparation. The home also has two large living rooms, allowing space for people to choose to spend time alone or join in small group activities. One person, who came to live at Bromley road last year, was able to bring her much loved pet cat, this being clearly important to her. Files detail each Ormerod Home Trust DS0000010017.V340476.R01.S.doc Version 5.2 Page 16 persons’ preferred from of address and during the inspection staff prompted the inspector to use the name preferred by one gentleman at the home. People living at the home can choose to eat their meals in the dining kitchen or in the second lounge at the rear of the home, which has a small table at one side. One person spoken to stated that he preferred to eat his meals in this room. The kitchen has space for dining and means that those living at the home can help with some of the preparations such as laying the table, or just watch the kitchen activity. Staff explained that a menu is drawn up each week and that this helps to plan the shopping requirements. The people living at the home take part in the food shopping, with one or two individuals accompanying a staff member on trips to the supermarket. Files recordings detail individual likes and dislikes, which staff are well aware of. Individuals are supported to eat a healthy diet and weight is monitored as necessary. Ormerod Home Trust DS0000010017.V340476.R01.S.doc Version 5.2 Page 17 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is good. Personal care needs and medication needs are met. Health care records could be improved to allow for a better overview of treatment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Personal care needs are detailed within the individual support plan for each person. Times for going to bed and getting up are flexible and vary according to the activities planned for each day. At the last inspection it was advised that records of personal care should be maintained individually and not in the communication book and this advice has been followed. A daily record sheet is completed in respect of each person living at the home and although some contain good information, some records are brief and do not give a full picture of how that person has been that day. The quantity and quality of the daily records could be improved. This also applies to some of the person centred planning monitoring of goals records. Records show that specialist advice is sought when necessary. Files contain good information regarding health care needs. These include multi agency Ormerod Home Trust DS0000010017.V340476.R01.S.doc Version 5.2 Page 18 health care assessments and health action plans. Where necessary, records are kept of seizures, continence and weight. A seizure management plan is in place, guiding staff in how to respond to this area of need. Ormerod has developed a policy regarding consent to medical treatment. Files give good information regarding how individuals respond to health care, such as dental or chiropody treatment. Each file contains records of appointments, such as GP, chiropody and dentist visits. However for one individual, there was no record of the reason or outcome of two health appointments recorded on the calendar. Although staff were aware of the reasons and outcomes for these appointments, clear records should be maintained. This appeared to be an oversight. The provider organisation has produced specific health appointment record sheets, but these are not being consistently used at Bromley Road, with this information being recorded on the daily record sheet. The organisations’ health appointment record sheets would allow for easier tracking of any health practitioner input. Feedback via questionnaires completed by health care professionals indicates that staff seek advice when necessary. Medication is stored in locked cupboards in the cellar, which is only accessible to staff. Medication records include a photograph of the person. Drug information leaflets are available for staff information. The staff member spoken to confirmed that she had undertaken medication training and the training records provided by the registered manager show that all the team have received this training and when refresher training is due. Apart from one minor omission, which was immediately rectified, the medication administration records viewed were completed appropriately. Improvements have been made since the last inspection. Although no one at the home was being prescribed medication, which required fridge storage, the staff member spoken to confirmed that the fridge in the cellar would be used if necessary. Containers for taking medication out of the home, such as on a day trip out, are now labelled with details of the contents. Written guidance for when taking medication out of the home is now included within the medication policy. Ormerod Home Trust DS0000010017.V340476.R01.S.doc Version 5.2 Page 19 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. Arrangements for handling complaints are in place. Policies, procedures, good practice and staff training promote the protection of those living at the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There have been no complaints since the last inspection. A complaints procedure is in place. This is produced in plain text and with pictures, to aid the understanding of those living at the home. Good contact is kept with relatives, who would advocate on the individuals behalf if necessary. A social care professional with links to the home commented that; “On the occasion I did raise a concern, they did respond appropriately” The provider organisation has procedures in place, which promote the protection of those using the service. Staff recruitment includes appropriate checks. The records kept regarding the finances for two people living at the home were viewed. Arrangements for the safe keeping of money are good, with regular monitoring taking place. New staff undergo structured induction training, which addresses issues of abuse and protection. These are also covered within NVQ programmes. Ormerod Home Trust DS0000010017.V340476.R01.S.doc Version 5.2 Page 20 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is adequate. Some furnishings and parts of the home are poorly maintained and do not provide an attractive place for people to live. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is situated within walking distance of the beach and St Annes centre, giving easy access to a range of local amenities. Some redecoration and refurbishment has taken place since the last inspection, with a new suite in the main lounge, new stair carpet and the hall being decorated. The rear lounge/dining room is now back in use, after being used as a temporary bedroom for an individual with ill health. There are still areas of the home, which require attention. The shower areas, bathrooms and kitchen need updating. Some bedroom furniture and radiator covers are broken. Two people have bedroom flooring, which can be more easily kept clean than carpets, which is appropriate for their specific needs. Ormerod Home Trust DS0000010017.V340476.R01.S.doc Version 5.2 Page 21 However another person, who moved into the home last October still has lino on her bedroom floor and this room should be carpeted. The registered manager informed the inspector that there are plans for a Housing Association to buy the property and that this would then lead to refurbishment of many areas of the home. As there is no definite timeframe for this change of ownership, the provider organisation must address some of the areas identified in this report. The repair/renewal of the radiator covers, re grouting of showers/bathrooms and the carpeting of one of the bedrooms would improve the home in the short term. The support workers are responsible for domestic, laundry and cleaning tasks at the home and work hard to maintain a reasonable level of cleanliness and hygiene. The redecoration programme is taking some time, making it difficult to keep the home looking clean. The home appeared generally clean. The lay out of the home means that soiled articles have to be brought through the kitchen to the laundry area. Procedures are in place to reduce the risk of infection. Ormerod Home Trust DS0000010017.V340476.R01.S.doc Version 5.2 Page 22 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 and 36 Quality in this outcome area is excellent. Qualified, capable and well-trained staff, who receive excellent guidance and supervision from managers, support the people living at the home. The robust recruitment procedures help to maintain this high quality of staffing. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There are six staff on the support team, including a senior support worker who carries out some managerial tasks at the home. The registered manager oversees the work of the team. NVQ training is strongly promoted and all the staff have now achieved NVQ level 2 or above, with three members of the team having also achieved level 3. Ormerod provides excellent opportunities for qualification training, which is highly valued by staff. Staff appeared to be motivated and demonstrated good communication skills, assisting the inspector to communicate with the people living at the home. The atmosphere was relaxed and the relationships between staff and individuals living at the home appeared to be positive. A review of the staffing arrangements has been carried out. At present there are two staff on duty each morning and evening, with one person working Ormerod Home Trust DS0000010017.V340476.R01.S.doc Version 5.2 Page 23 during the day, on a one to one basis with one person living at the home. During the day, the other people are, in the main supported by staff from the Ormerod resource centre. More one to one support during the day would allow for individual activities and more real choice for each person. Senior staff within the organisation are aware of the issues and are trying to address this by acquiring an increase in funding for these people. The file for one member of staff was viewed and evidenced that appropriate recruitment practices are being followed. Documentation includes an application form, two references, criminal records bureau disclosure, health questionnaire, emergency contact details, contract and code of conduct. Ormerod operates a six-month probation period. A number of people supported elsewhere within Ormerod services have received specific training and are involved in staff selection. The feedback sheet completed by the service user involved in the selection of this staff member was viewed. The interview process also includes a written exercise, which was available on the recruitment file viewed. Ormerod provides an excellent staff-training programme. Training is organised by a dedicated training team based at the main office. Records show that new staff follow a seven-day induction programme, which covers the Learning Disability Award Framework induction standards. Staff are then encouraged to register for NVQ programmes, once the six-month probation period has passed. The induction of new staff also includes a house based induction programme, with a checklist showing when each topic has been covered. There is a rolling programme of core training, with dates being set for the year. This covers topics such as moving and handling and first aid. Training is also arranged according to the specific needs of the people living at Bromley Road. Five of the team have attended a course on dementia and this is planned for the remaining member of staff. This training has been arranged to benefit an individual who lives at the home, who has a diagnosis of dementia. A training matrix for the organisation shows what training has been completed and when refresher courses are due. Each staff member now has a nominated member of the training team, who meets with that person to carry out a training assessment, which is regularly reviewed. All training dates are then set for the forthcoming year. This has been introduced in order promote staff responsibility and ownership of their professional development. This is an improvement to an already excellent system for arranging and providing high quality training for staff. There are excellent supervision arrangements in place for staff. The senior support worker works hard to carry out supervision sessions with support workers at the home. Records show that staff receive supervision approximately every four to six weeks and that supervision meetings between the registered manager and the senior support worker also take place regularly. Supervision meetings address various topics, including training and identify any action required. Staff files contain a copy of the supervision Ormerod Home Trust DS0000010017.V340476.R01.S.doc Version 5.2 Page 24 agreement. Staff meetings take place regularly and minutes are maintained. Arrangements for annual staff appraisals are now in place. The annual appraisal includes a self-appraisal by the staff member concerned and a personal development plan. The supervision and appraisal system is excellent, meaning that staff are well supported and guided in their work. Ormerod Home Trust DS0000010017.V340476.R01.S.doc Version 5.2 Page 25 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality in this outcome area is good. Sound management systems are now being followed and the quality assurance systems are excellent, giving a range of opportunities for people to provide feedback about the service provided. Staff training, policies and good practice promote the health and safety of those living and working at the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The team leader of the home is qualified and experienced and registered with the CSCI. Qualifications include a supervisory management certificate, the NVQ assessor and verifier awards, level 4 NVQ and the Registered Managers Award. During discussion, it was confirmed that regular update training is also Ormerod Home Trust DS0000010017.V340476.R01.S.doc Version 5.2 Page 26 undertaken, with recent courses including fire safety and dementia. Regular staff meetings and supervision sessions take place. The range of quality monitoring systems is excellent. There are internal and external quality monitoring systems in place. Ormerod has achieved the Investors in People Award and is also affiliated to the Quality Review network, which carries out quality monitoring work with and for people with learning disabilities. The most recent work of the review team has focussed on the lives of people within the area who have complex needs. There is a suggestion box in the entrance to the Ormerod main office, inviting ideas and feedback about the service provided. The registered manager carries out a monthly audit and a senior manager within the organisation undertakes monthly visits, with reports being sent to the CSCI. The registered manager’s audit includes the monitoring and relevance of policies, which helps to ensure that they are appropriate and being put into practice. Questionnaires have recently been sent to all people using Ormerod services, including those living at Bromley Road. The responses have been collated, with the inspector being provided with a copy of the associated report. The report includes an action plan to address areas of possible service improvement indicated by the responses received. Ormerod has introduced a new logo for the organisation, with staff and people living at the home being invited to vote on the logo of their choice, showing that the views of people who use the service are valued. Staff and people who use Ormerod services are represented at learning disability and community partnership forums, where there is opportunity to contribute to wider planning and decision-making. A newsletter is produced and circulated, keeping everyone up to date, with articles including recent holidays or pieces of good news. Person centred planning is now being established at Bromley Road and is a vital element of quality assurance, giving all those involved, including relatives, an opportunity to give feedback about the service and to support the individual to plan for the future. The improvements in this area should be maintained and built upon. The provider organisation has a designated member of staff, who undertakes monthly health and hygiene audits of the home, with a report being compiled. These visits focus on food hygiene, food storage and cleanliness. The wellorganised training programme addresses key areas of health and safety such as first aid and food hygiene. The annual quality assurance assessment, completed by the registered manager, confirms that maintenance checks are complied with. Records viewed included, the record of checks for electrical appliances, the gas safety checks, the fire procedure, record of fire drills, record of fire equipment being checked and the record of fridge and freezer Ormerod Home Trust DS0000010017.V340476.R01.S.doc Version 5.2 Page 27 temperatures. Although the water temperature is thermostatically controlled, it was advised at the last inspection that some monitoring of water temperatures should still place place. This is recommended as good practice and should be implemented. Ormerod Home Trust DS0000010017.V340476.R01.S.doc Version 5.2 Page 28 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 4 33 X 34 3 35 4 36 4 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 3 X 3 X 4 X X 3 X Ormerod Home Trust DS0000010017.V340476.R01.S.doc Version 5.2 Page 29 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA24 Regulation 23(2)(d) Requirement All parts of the home must be kept reasonably decorated. (The agreed timescale of 28/10/06 has not been met) Timescale for action 30/10/07 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 YA19 Good Practice Recommendations Records should be kept of all health care appointments, with detailed information regarding the reason and outcome. The repair/renewal of the radiator covers, re grouting of showers/bathrooms and the carpeting of one of the bedrooms should be carried out. Water temperatures should be monitored and records kept. 2. YA24 3. YA42 Ormerod Home Trust DS0000010017.V340476.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Lancashire Area Office Unit 1 Tustin Court Portway Preston PR2 2YQ 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 Ormerod Home Trust DS0000010017.V340476.R01.S.doc Version 5.2 Page 31 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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