Inspection on 16/11/06 for 2a Court Road

This inspection was carried out on 16th November 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 no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

2a Court Road 12/12/08

2a Court Road 30/11/07

2a Court Road 21/02/06

2a Court Road 13/01/05

2a Court Road 10/08/04

2a Court Road 18/02/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 2a Court Road Kingswood South Glos BS15 9QB Lead Inspector Odette Coveney Key Unannounced Inspection 16 to 23 November 2006 09:30a 2a Court Road DS0000003374.V311279.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 2a Court Road DS0000003374.V311279.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. 2a Court Road DS0000003374.V311279.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 2a Court Road Address Kingswood South Glos BS15 9QB Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0117 961 8737 0117 9607195 admin@aspectsandmilestones.org.uk Aspects and Milestones Trust Mrs Tracy Jean Cunningham Care Home 15 Category(ies) of Learning disability (15) registration, with number of places 2a Court Road DS0000003374.V311279.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. May accommodate up to 15 persons aged between 18-64 years with Learning Disabilities 21st February 2006 Date of last inspection Brief Description of the Service: 2a Court Road is located in an established residential area of South Gloucestershire within approximately a quarter a mile of the shopping area of Kingswood where most community facilities exist. Public transport (buses) is available to Bristol City Centre, which is approximately four miles away. The home is purpose built and was opened in 1996. It has three houses within the same building. Two houses have single level accommodation, while the middle house is based on two floors with stairs to the first floor. Each house accommodates five people and consists of individuals’ bedrooms dining room and lounge. Kitchen and bathrooms. There is an activity room and staff administration offices. There is sleeping-in accommodation for staff. The staff team is approximately 38 in total. Aspects & Milestones Trust, a voluntary non-profit making organisation, runs the home. All of the clients previously lived in Stoke Park Hospital and moved to 2a Court Road when it opened in 1996. All of those living within the homes have profound learning difficulties. 2a Court Road DS0000003374.V311279.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The purpose of the visit was to establish if the home is meeting the National Minimum Standards and the requirements of the Care Standards Act 2000 and to review the quality of the care provision for the individual’s living in the home. This inspection employed key elements of the national inspection methodology with the objectives of focusing on outcomes for the individual’s. This is evidenced through evaluation of core standards and verification through a surveying and case tracking approach that included talking with and the observation of individuals who live at the home and the views of the manager on duty. An opportunity was taken to view the home and a number of the records relating to the management of the home and plans of care for two individuals from each house were reviewed. As part of this inspection visit an ‘expert by experience’ and their support worker accompanied the inspector. Their focus was to spend time with those who live and work at the home, to view the facilities and to provide an unbiased view from the perspective of those who live at the home, their comments were fedback and discussed with the manager at the inspection and some of these have been incorporated within this report. Throughout the inspection process the registered manager and staff spoken with were informative and engaged fully with the inspection. Service users appeared general at ease with the staff and relaxed within the home. The inspector received a number of comment cards from those who live at the home, relatives and healthcare professionals and these have been shared with the management and have also been incorporated into the body of the report. What the service does well: The homes assessment processes and the information available about the home ensures that placement is offered to those people whose needs they can meet. The homes care-planning processes will ensure that each individual receives the care they need. Individuals are able to participate in a range of meaningful activities and spend their time as they wish. Those living at Court Road can be assured that any complaints they have will be dealt with and that they will be safeguarded from any harm. 2a Court Road DS0000003374.V311279.R01.S.doc Version 5.2 Page 6 Those living at all three houses are cared for as “individuals” and the staff team are knowledgeable about each person’s likes and dislikes and essential lifestyle information that is important to the person living at the home. The home is well managed and run in the best interests of those who live there. What has improved since the last inspection? What they could do better: The environment for those living at the home would be better maintained if areas of the home were redecorated and if carpets were replaced. These issues have been outstanding since the last inspection. The manager explained that due to proposed refurbishments these areas had not been addressed and would be incorporated when the works commence. As this has been an ongoing issue for some time it is required that the Trust contact the landlord of the home, Western Challenge and obtain from them written confirmation of when the building works will commence in respect of the refurbishment of the 2a Court Road DS0000003374.V311279.R01.S.doc Version 5.2 Page 7 kitchen and bathroom areas, this information to be forwarded to the Commission. It is required that staff are reminded of their responsibility to respect the privacy of service users. In order to ensure information written about service users is respectful it is recommended that staff consider their use of language in individuals daily records, it is further recommended that essential lifestyle information at houses 2 & 3 are ‘tidied up’. To ensure that recognition is given to the safety of all it is required that information entitled ‘how to keep me healthy and safe’ should include how individual lives could be affected by the behaviour of others in order that they may be supported appropriately. The home has some pictorial menu choices in place for service users, in order to offer a wider choice it is recommended that information in place be expanded upon. 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. 2a Court Road DS0000003374.V311279.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 2a Court Road DS0000003374.V311279.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): 1,2,3,5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Clear information is available for service users about the services provided. Contracts or the terms and conditions of the placement are in place, which record the rights and responsibilities of both individuals and the home. EVIDENCE: 2a Court Road is a settled household and individuals have lived together for a number of years. There have been no new admissions for a many years. Comprehensive care management and health need support plans have previously been seen on file. The home has developed comprehensive person centred plans based on wishes and choices from the information provided by the individuals and information gathered during the assessment process, the trial period and as part of the ongoing placement within the home. The daily records maintained within the home provide clear evidence that individual’s current and changing needs are identified and met. Clear information was in place to show the involvement of specialist services and professionals, ensuring a multi-disciplinary approach. The Statement of Purpose was in place and this was found to be fully comprehensive and contained all of the relevant information required as stated 2a Court Road DS0000003374.V311279.R01.S.doc Version 5.2 Page 10 in Schedule 1, Regulation 4(1)(c). The Statement of Purpose contained the aims and objectives of the home and spoke of treating individuals with dignity and respect, to promote independence and encourage individuals to make choices with aspects of their lives. The document also contained the relevant qualification and experience of the manager and staff team. The document outlines the needs that can be supported at the home. At this inspection the terms and conditions of the placement, licence agreements, were viewed for six service users. This was to review the requirement made at the last inspection that was to ensure that this document had up to date information about the fees and recorded what was, and was not included within this. All documents reviewed contained the required information and had been dated, signed and explained to the service users. Staff were observed communicating with individuals effectively using the communication most suited to the needs of the individual. This included differing voice tone, gestures, sign language, and the appropriate use of touch. 2a Court Road DS0000003374.V311279.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, 7,9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home operates with a good person centred perspective for all. Care plans and risk assessments are extremely detailed and are regularly reviewed and updated to reflect the individual’s currently changing needs and choices to ensure that the correct level of support is required. Staff should give consideration to the use of language and terminology within daily records and essential lifestyle information in two of the houses are in need of minor attention. EVIDENCE: The care documentation for six of those living at 2a Court Road was examined during this inspection. (This was two service users from each house). It was evident that the care planning information had been generated from a care manager’s assessment as well as the homes initial assessment. Daily records, essential lifestyle documents and care-planning information was in place for all of the six individuals. Documentation examined by the inspector was found to be recorded with a high level of information and it was clear that the information had been gathered over a long period of time with the individual involved being central to the whole process. The information in place recorded 2a Court Road DS0000003374.V311279.R01.S.doc Version 5.2 Page 12 the individual’s preferred routines and an overview of an individual’s day and well being, these are written in on a daily basis. It was found that essential lifestyle information in houses 2 & 3 in need of ‘tidying up’ due to their condition, it is, however, recognised that these are ‘live’ working documents’ that change frequently and change had been recorded. These care planning records note what individuals have done during the day and cover areas of communication, healthcare, activities of daily living, social activities and behavioural monitoring. These records demonstrated that routines for individuals are flexible and tailored to individuals expressed wishes and choices. Care planning information is updated and re-written as and when there is an area of identified need. Each house assistant manager had developed a system of regular review of the care plans and these had been recorded. Daily records were reviewed in all three houses and it was noted that general these had been well written, all entries were dated and signed by staff and recorded choices that individuals had made these records also demonstrated that individuals wishes were respected, however, it was noted that there were entries which had used inappropriate descriptors of service users, it is recommended that staff give consideration to their use of language and terminology within these records in order that they remain respectful. The home has developed comprehensive risk assessments. These have been produced within a risk management framework, without impacting on individual’s expressed choices. These assessments ensure that staff enable individual’s to take responsible risks, ensuring they have they good information on which to base decisions. This is completed within the context of the service users individual plan and of the homes risk assessment and risk management strategies. Action is taken to minimise identified risks and hazards. 2a Court Road DS0000003374.V311279.R01.S.doc Version 5.2 Page 13 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): 11, 12, 13 14,15, 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Individuals are offered opportunities to personally develop, to participate in activities of their choice and to access community facilities. Some improvement could be made to the menu pictorial choice cards for service users. EVIDENCE: Staff enable service users to have opportunities to maintain and develop social, emotional, communication and independent living skills. This was varied and confirmation that activities have taken place was evidenced through written Documentation seen and discussion with the manager and a staff members. Staff support service users to become part of, and participate in, the local community in accordance with assessed needs and individual plans. Staff enable service users integration into community life through knowledge and support to enable service users to make use of services, facilities and activities in the local community, such as shops, pubs, and leisure centres. Information seen by the inspector, and confirmed by staff and seen on individual’s records 2a Court Road DS0000003374.V311279.R01.S.doc Version 5.2 Page 14 showed that those living at the home are offered a variety of social, leisure and educational activities. Individuals are able to participate or not, this is dependent on the individual’s choice. Information seen in daily records evidenced that individuals regularly take part in the following activities such as Bingo, attending discos, parties, rambling, shopping, swimming, drama, attendance at college and visiting places of local interest such as Chew Valley lakes and Westonbirt Arboretum. It was clear that the home regularly review the activities that individuals participate in and monitor these to ensure that individuals are benefiting from their experiences. Richard Edwards; an ‘expert by experience’ spent some time with the staff team and noted; I was shown one of the resident’s communication books which had a lot of information about the resident in it. This book was shown to new bank staff. Permanent staff were given more in-depth training. All staff did training including communication. Recently they have been learning a type of sign language, as some of the residents may be able to communicate this way. The staff said that they always try to ensure the residents can make choices. They are all offered an individual holiday each year where they go with someone in their care team. Staff show the residents pictures of things they enjoy and find suitable holidays around this. Eg. One resident likes walking and another horse riding so their holidays included the activity. On the whole I did think the houses were homely and the residents were offered choices and the staff were having training to help communication with the residents. The residents did seem to be happy, relaxed and content. Seven comment cards were received from relatives prior to the inspection. Comments included:’ we feel happy with the care and attention given to our relative’. ‘All the staff and Mrs Cunningham are very good, both to me and my relative at all times’ ‘ I think the staff on house 1 are loving and caring people and I would like to thank them all for the loving care and attention they have given my relative’ ‘ I have always found the staff welcoming, helpful, interested and professional. ‘An example of care in the community working well’. Staff support individuals to maintain family links and friendships inside and outside of the home and this is facilitated by staff assisting individuals with correspondence, telephone calls and escorting individuals on visits to family members. Information was seen to demonstrate that individuals are supported to maintain their cultural identity. Information was seen, as confirmed by the manager, that each house has identified their own ‘pathway’ as a team to develop their own plan as a team to 2a Court Road DS0000003374.V311279.R01.S.doc Version 5.2 Page 15 forward plan, this links into the organisations and the homes own business plan as well as the governments ‘Valuing People’ document. Staff confirmed that menus are tailored to the choices and dietary requirements of the service users, and whilst the inspector was in House 1 at lunchtime it was seen that individuals were asked what they would like and three different lunches were provided. Information seen within individual’s essential lifestyle information of likes and dislikes recorded individuals food preferences. Each house had some information in pictorial format in order that individuals can be offered a meal choice; it is recommended that in order that individuals are offer a full choice these menus be expanded upon. 2a Court Road DS0000003374.V311279.R01.S.doc Version 5.2 Page 16 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, 20, 21. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Individuals are well supported by staff and external agencies with all aspects of their personal, physical and emotional well-being. Information should be expanded upon within the records of ‘how to keep individuals healthy and safe’. Legal requirements in respect of medication are appropriately met. EVIDENCE: The care documentation in place, sampled, provided clear guidance for staff on how they should support individuals with their personal care, it had recorded individual’s preferences and the assistance required with personal hygiene and personal support. Staff described how they monitored an individual’s wellbeing and much was done via observations, as individuals did not always articulate their needs coherently and logically. This further evidenced that staff had a good awareness of the needs of those individuals with communication differences 2a Court Road DS0000003374.V311279.R01.S.doc Version 5.2 Page 17 Some individuals have complex needs and exhibit some behaviour which challenges, the inspector saw that the home monitors individual’s behaviour and the service provided is tailored to needs of the individual. Staff have received guidance and support to ensure they are equipped with the skills to support service users in an appropriate manner, risk assessments and behaviour strategies are in place to guide staff and to direct practice. Information was also seen within individuals records entitled ‘how to keep me healthy and safe’, these recorded information such as smoking, healthy food options. It has been required that these records include information on how the behaviour of others can impact in individuals lives and how staff can support them at this time to ensure their safety and emotional wellbeing. A support worker in house three showed the inspector the medication administration systems in place at the home. The staff member was fully conversant with their role and responsibility in this area and the importance of adhering to policies and procedures that are in place for the safe administration of medication. A review during the inspection revealed no errors. The medication was appropriately stored and was well organised. All medication records were up to date and in order. Staff confirmed they had received medication competency training, which is, reviewed a minimal of once per year. Prior to the inspection written feedback was received from a health professional who supports service users and staff at the home, there comments were; ‘I meet with each of the 3 teams regularly and provide occupational training as required I am pleased with the way ideas are generated and advice readily implemented’. All individuals are registered with a general practitioner and information was seen to show that individuals have access to health services as soon as a need has been identified; individuals have access to specialist services as well as accessing preventative healthcare checks such as cancer screening Richard Edwards assisted at the inspection within his role as an ‘expert by experience’; his comments are recorded; Staff asked if I wanted to see the residents’ bedrooms. I said that shouldn’t the resident be asked first and the staff said that they wouldn’t understand anyway. I was shocked with this comment as their bedroom is the residents place and is private for them. This was discussed with the registered manager who agreed that service users should be asked permission before anyone entered their room. A requirement was made that staff should respect individual’s privacy. It was noted at the last inspection that there were a number of individual’s who had no information recorded in respect of their wishes in the event of their death, it is understood that this is a difficult and sensitive subject, however it 2a Court Road DS0000003374.V311279.R01.S.doc Version 5.2 Page 18 was recommended that the home seeks and records individuals’ wishes in order that their choices will be respected. The home had worked diligently in order to gather this information as all service users had their wishes recorded. 2a Court Road DS0000003374.V311279.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, 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. . There are clear guidelines, policies and procedures in place to ensure that individuals are protected from abuse and staff have demonstrated responsibility in this crucial area of adult protection. EVIDENCE: The home has robust polices and procedures in place to ensure the protection of vulnerable adults. One of the staff members was asked about their understanding of what constitutes abuse and what their responsibilities in this area would be; the staff member told the inspector of the protection of vulnerable adults training they had undertaken, ensuring the rights of the service user were upheld, not making judgements and the importance of reporting and recording. This staff member demonstrated a sound understanding of this subject. The registered manager has contacted the Commission for Social Care Inspection to inform of incidents that have affected the wellbeing and safety of those living at the home. It was required at the last inspection that the home must ensure that money held for safekeeping on the behalf of individuals must be clearly accounted for and corresponds correctly with records held. No errors were found in any of the records of money held on behalf of service users. Individuals all had in place an inventory of their personal effect of values, these had been reviewed and items added when new purchases had been made. It is further noted that individuals moneys and records of these are checked a minimum of three times 2a Court Road DS0000003374.V311279.R01.S.doc Version 5.2 Page 20 per day and also the Trust also complete an annual audit of finances and accounts held on behalf of individuals at the home. In each of the six service users files reviewed it was found that all of them had a copy of the trusts complaints procedure, these had been provided in a pictorial format and contained all of the required information in respect of timescales and who to complain to and how they would be supported. Evidence in place showed that these procedures had been explained to individuals on a one to one basis. Complaint logbooks were reviewed; issues are recorded well and responded to as required in order to ensure the best outcome for the individuals involved. 2a Court Road DS0000003374.V311279.R01.S.doc Version 5.2 Page 21 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, 27, 28, 30. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The quality of furnishings and fittings in the home is good and overall a warm comfortable environment has been created ensuring individuals needs are met, however improvement is required to ensure that EVIDENCE: 2a Court Road is a residential care home for young adults located within the residential area of Kingswood. The house is close to local amenities such as s shops, public transport, cafes, banks, churches and public houses. 2a Court road is registered with the commission to accommodate young adults aged 1664. The home is made up of three self-contained houses each housing five individuals. Each house has lounge, kitchen and bathroom areas as well as each individual having their own private single room. Each house has its own staff team that is supported by an assistant home manager. There is an activities room for service users use. There is sufficient parking to the front of the home with an enclosed garden to the rear of the property. 2a Court Road DS0000003374.V311279.R01.S.doc Version 5.2 Page 22 At the last inspection that house one had a toilet area that required cleaning of the ceiling and the walls, there was another toilet in house one that requires a seat. It was noted that in the hallway of house one there is a ceiling light cover that was in need of replacing. In house three it was noted that a toilet had a broken lock, it was required that this lock be replaced or repaired in order to ensure the privacy for clients who use this facility. The following recommendation was also made at the last inspection: that the carpet to be cleaned in the link corridor due to stains that were evident and also that lounge three be redecorated. The home is to be commended for meeting all of the above requirements and recommendations The following areas in need of attention were raised at the last inspection and no action has been taken to rectify these. House House House House 1: 3: 3: 3: Lounge carpet to be replaced. Lounge carpet to be replaced. Carpet in entrance hall to be replaced. Toilet area to be redecorated. Discussion took place with the manager and with staff in each of the houses about the proposed refurbishment of the houses. These proposals have been in place for a number of years and include refurbishment of both kitchen and bathroom areas in order to provide a better environment for those who live at Court Road; it is required that the Trust provide confirmation of when works will commence and that this information is forwarded to the Commission in order that the situation and timescales can be monitored. 2a Court Road DS0000003374.V311279.R01.S.doc Version 5.2 Page 23 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, 35, 36. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There are clear aims and values in this home, which are individually focused and centre on the choice, rights and self-determination of the individual. Staff were able to clearly demonstrate this philosophy and it was evident that sound relationships had been forged between the staff and those living in the home It was recommended at the last inspection that the home ensure that records of staff training be updated in order to fully reflect training that had been undertaken. This had been met and recording in this area had improved. Staff confirmed that they had completed both statutory and specialist training such as manual handling, first aid and Values training. Formal supervision with staff is taking place on a regular basis. A staff member spoke of the purpose of these meetings in order to ensure that individuals are supported according to their preferred routines and preferences and also so that staff are guided and given appropriate information in order to fulfil their duties. 2a Court Road DS0000003374.V311279.R01.S.doc Version 5.2 Page 24 At the inspection the inspector sat in on a house meeting at House 2; all staff fully engaged with the process and were provided with an opportunity to air their views, be involved in decision making processes and future planning. Individual’s service users needs were discussed and strategies were discussed to ensure that individuals care plans, wishes and aspirations were evaluated. Team events are held on a regular basis and the inspector saw notes from these; the event covered areas such as fire safety, values of the organisation, record keeping, health and safety and food hygiene. These demonstrate a commitment in ensuring continuity of service delivery and consistency of standards. 2a Court Road DS0000003374.V311279.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, 38, 40, 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Both the manager and assistant managers at 2a Court Road are qualified, skilled and experienced. The management ensure an open and inclusive atmosphere is present in the home, which is run in the best interest of those living at the home. Health and safety of those living and working at the home is well managed EVIDENCE: Throughout the inspection process, as during previous inspections Mrs Cunningham was able to demonstrate that she is qualified, competent and experienced to run the home and meet its stated purpose, aims and objectives. She has a sound understanding of the diverse and complex needs of those living at Court Road and is committed to ensuring that staff are working with individuals in a person centred way. 2a Court Road DS0000003374.V311279.R01.S.doc Version 5.2 Page 26 The inspector viewed the organisational policies and procedures in place at the home, these are robust and provide sufficient information in order to direct and guide staff practice. The policies seen were appropriate to the service provided at the home. Individual’s rights and best interests are safeguarded by the organisational policies and procedures. Staff meetings are held regularly and there are also other strategies for enabling staff, clients and other stakeholders to voice concerns and to affect the way in which service is delivered. These included staff supervision, client review meetings, quality assurance, and an open and approachable management approach. It was also reported that the person who visits the home on behalf of the responsible individual visits the home on a regular basis, spends time with service users, staff and the manager and oversees the service provided at the home. A requirement was made at the last inspection that improvements must be made in forwarding the regulation 26 reports of visits made to the home; this has improved and reports are forwarded on a consistent basis. The fire logbook for each house was reviewed and each of these had been well maintained, fire drills, equipment, and fire safety checks had all been completed as required. All staff had undertaken appropriate, sufficient training. Each house had also a fire risk assessment in place covering all potential hazards. Each house complete monthly health and safety areas which evaluate the safety of the environment of service users and the staff who work in the home, no issues of concern were identified within these. Incident and accident reports were reviewed at this inspection, situations had been responded to appropriately with clear-recorded information in place to demonstrate that individuals are supported. 2a Court Road DS0000003374.V311279.R01.S.doc Version 5.2 Page 27 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 3 4 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 2 25 X 26 X 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 3 32 X 33 X 34 X 35 3 36 3 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 3 12 3 13 3 14 3 15 3 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 3 3 X 3 X 3 X 2a Court Road DS0000003374.V311279.R01.S.doc Version 5.2 Page 28 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) Requirement Timescale for action 16/02/07 2. 3. YA18 YA23 12(4) a 13(4) c For the Trust to forward confirmation of when the refurbishment works are to commence at the home. To respect the privacy and 16/11/06 dignity of service users. Information in respect of keeping 16/01/07 individuals healthy and safe to be expanded upon. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 5. Refer to Standard YA28 YA28 YA28 YA30 YA6 Good Practice Recommendations House 1: Lounge carpet to be replaced. House 3: Lounge carpet to be replaced. House 3: Toilet area to be redecorated. House 3: Carpet in entrance hall to be replaced. Consideration should be given to the use of language and terminology within written daily records. DS0000003374.V311279.R01.S.doc Version 5.2 Page 29 2a Court Road 6. YA6 To ‘tidy’ essential lifestyle documents in houses 2 & 3. 2a Court Road DS0000003374.V311279.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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