Inspection on 18/07/06 for 346b Newton Road

This inspection was carried out on 18th July 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

346b Newton Road 15/11/05

346b Newton Road 21/04/05

346b Newton Road 15/09/04

346b Newton Road 04/05/04

Similar services:

Ruskin Lodge

Clover House

Dystlegh Grange

The Good Companions

Cuerden Grange Rest Home

Springfield Cottage

Parkside

Park Lodge

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

CARE HOME ADULTS 18-65 346b Newton Road 346b Newton Road Lowton Nr Warrington Cheshire WA3 1HF Lead Inspector Kath Smethurst Key Unannounced Inspection 18th July 2006 09:30 346b Newton Road DS0000005752.V295593.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 346b Newton Road DS0000005752.V295593.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. 346b Newton Road DS0000005752.V295593.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 346b Newton Road Address 346b Newton Road Lowton Nr Warrington Cheshire WA3 1HF 01942 676555 01942 676555 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) Nugent Care Mrs Tomina Teresa Roden Care Home 4 Category(ies) of Learning disability (4), Learning disability over registration, with number 65 years of age (1), Physical disability (4) of places 346b Newton Road DS0000005752.V295593.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The home is registered for a maximim of 4 service users to include:up to 4 service users in the category of LD (Learning Disability) up to 4 service users in the category of PD (Physical Disability) The service should employ a suitably qualified and experienced manager, who is registered with the Commission for Social Care Inspection. One named service user (DC) may be admited in the category of LD(E) Learning Disability over 65 years of age). The Home`s categories of registration must revert back if DC is no longer accommodated at the home. 15th November 2005 Date of last inspection Brief Description of the Service: 346B Newton Road is a care home located on the grounds of Lime House care home on the outskirts of Lowton, and is managed by the Nugent Care Society. The property is a bungalow with three single bedrooms, a lounge, conservatory/dining room, kitchen, bathroom and WC. There is a reasonable level of public transport in the area, however, residents use taxis or wheelchair accessible transport. The home provides twenty-four hour care and accommodation for up to four residents with a learning disability and a physical disability. A standard fee of £362.02 per week is charged. 346b Newton Road DS0000005752.V295593.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over six and a half hours. The home had not been told that the inspector would visit. The inspector looked around parts of the building and checked some paper work about the running of the home and the care given. To get more information about the home all three residents, the acting manager and two staff were spoken with. Carers were also watched as they went about their work. Before the inspection comment cards were sent to residents, their relatives and people such as social workers, district nurses and doctors. Two residents, two relatives, 1 district nurse and 1 doctor returned comment cards. What the service does well: From speaking with residents and information relatives gave in comment cards, it was clear they were happy with the care and support provided. A resident who returned a comment card said, “I like where I live”. Residents said they liked living in the home and that staff treated them well. This was observed during the inspection. Residents had no hesitation in approaching staff members if they wanted to speak to them. Staff helps residents to lead interesting lives by arranging social activities in the home, regular trips out and holidays. Relatives who returned comment cards said they could visit at any time and staff always made them feel welcome. The records kept on residents (care plans), includes a lot of information about the things residents needs support with and the things they like to do. This means staff have the information they need so they can make sure residents get the care and support they need. The home is good at making sure residents health was taken care of by seeing doctors and other health care workers. Staff have done a lot of training, which helps them look after residents properly. The home makes sure that before staff start work they are properly checked to make sure they are suitable to care for people living in the home. 346b Newton Road DS0000005752.V295593.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. 346b Newton Road DS0000005752.V295593.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 346b Newton Road DS0000005752.V295593.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this area is good. This judgement has been made from the evidence gathered both during and before the visit to the service. The home provides a consistent and stable home environment, where residents’ care and support needs are being met. The admission procedure is satisfactory and systems are in place to ensure proper assessments are completed prior to people moving in. EVIDENCE: There have been no new admissions since the last inspection. All the residents living in the home have lived there for a long time (between eight and sixteen years). Residents and relatives who returned comment cards indicated they had been supplied with sufficient information prior to admission. The files of two residents were examined. Each resident has an assessment file, which includes ‘information about me’, ‘things I do’, ‘looking after myself’ and ‘about my health’. This document is comprehensive and gives a full understanding of each individual’s strengths, needs and aspirations. The assessment is completed with the resident and is a user friendly, working document. The acting manager advised that a new resident would not be admitted without a full assessment being carried out by both the homes staff and funding authority. 346b Newton Road DS0000005752.V295593.R01.S.doc Version 5.2 Page 9 From discussions with the acting manager it was evident that any future admissions would be handled appropriately. The acting manager said prospective residents would be offered the opportunity to visit prior to admission. Part of the process would include an overnight stay. This would allow staff and existing residents to come to a decision as to compatibility with existing residents and whether needs could be met. A resident who returned a comment card confirmed this process had taken place. He wrote, “ I came to the home for weekends to see if I liked it”. 346b Newton Road DS0000005752.V295593.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in this area is good. This judgement has been made from the evidence gathered both during and before the visit to the service. A good care planning system is in place, which provides staff with the information and guidance they need to ensure resident’s needs are met. Residents are consulted in all aspects of home life and personal support is offered in such a way as to promote residents to make decisions. The home encourages residents to be as independent as possible, helping them to keep any risks to their health and welfare to a minimum. EVIDENCE: Two care plans were looked at. They contained an extensive amount of personalised and very detailed information about residents’ health and social care needs. This included individual and risk issues, and each resident’s daily routines and how they liked their care to be provided. For example one plan read, “On waking X likes five minutes to wake up properly” and “Once in chair can brush own teeth and shave himself” and “Likes watching soaps”. Care plans take note of resident’s religious preferences and needs. 346b Newton Road DS0000005752.V295593.R01.S.doc Version 5.2 Page 11 Records showed that the resident and staff reviewed residents’ needs and goals on a regular basis. Records of that each resident is actively involved and records are maintained. For example in one review meeting one of the residents commented, “I like living at the home because the people are nice and staff are like a second family”. Discussion took place in regard to reviews undertaken by external agencies such as Social Services. The acting manager advised that they are not routinely undertaken. Staff have been told (by Social Services) they can contact residents social workers if there are any urgent issues and an external review will be arranged. Staff advised that they would not hesitate to contact social workers should the need arise. The routines of daily living were observed to be flexible. For example residents were observed getting up in the morning at times that suited them and to choose where they spent their day. Residents spoken with also confirmed they had a choice about daily routines. Residents are consulted on an informal day-to-day basis on all aspects of home life, their interests and preferences. Residents meetings take place regularly and minutes are maintained. The last residents meeting took place on the 7th July 2006. Topics discussed included activities, holidays, meals and meal times, the premises and social inclusion. Discussion with residents indicated they were well informed about how the home was run for example the new bathroom, the manager’s absence and planned holiday. Most residents had family or friends who could speak on their behalf. Details of advocacy services are provided to residents. A full range of risk assessments are in place covering areas such as moving and handling, bathing, toileting, travelling and community based activities. Records showed that potential risks had been assessed, and balanced against the resident’s right to choice and independence. For example one resident prefers to go out in the community alone, this resident understood his risk assessment and adheres to it. Staff transport this resident to Leigh town centre, where he uses his motorised wheelchair and go shopping, keeping in touch with staff using a mobile phone. 346b Newton Road DS0000005752.V295593.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 & 17 Quality in this area is good. This judgement has been made from the evidence gathered both during and before the visit to the service. Residents took part in activities both outside and within the home that reflected their choices and preferences. Residents are supported to maintain contact with relatives and friends. Practices in the home respect residents’ rights to privacy, dignity choice, and independence. Meals are good and the needs of residents are well catered for with a balanced and varied selection of food provided. EVIDENCE: Discussion took place in regard to the changing needs and interests of the residents living in the home. One resident has reached retirement age while 346b Newton Road DS0000005752.V295593.R01.S.doc Version 5.2 Page 13 another resident is close to retirement age. Neither wish to pursue further education or employment. The remaining resident has also indicated to staff that he did not wish to attend college or seek employment. Staff advised that this resident had gone to college in the past but has declined to attend any further courses. . While it is acknowledged this response can be discouraging it is important opportunities continue to be offered with future discussions recorded. None of the residents attend day centres. The acting manager advised this was due to the local authority policy whereby individuals living care homes are not allocated a day centre place. The older residents prefer to take part in activities in the home but they do enjoy trips out. For example the Sunday before the inspection residents had been to Fleetwood for the day. All residents spoken with had enjoyed the day. Two of the residents told the inspector about their recent holiday at the Bond Hotel in Blackpool. The Bond hotel has been adapted to cater specifically for people with a learning disability and a physical disability. Both residents spoken with said how much they enjoyed the holiday and were hoping to go again. One resident said, the entertainment was “Good” and they had “A lot of fun”. The younger resident is able to access community facilities alone and has a good social life. Staff have carried out a risk assessment, which allows the resident to go out alone into Leigh town centre. The resident is very independent and goes into Leigh shopping twice a week, meets friends and relatives for lunch and is involved in the local church and its social club. The older residents living in the home needed staff support for community activities. One to one and group trips are arranged. Records of activities are maintained and showed evidence of residents using community facilities. For example outings to Wales, Manchester Airport, Rivington, pub lunches and shopping. At home residents liked to listen to music or watch TV. One of the older residents spoken with does not wish to go out as often preferring to occupy his time at home. This resident enjoys listening to music, watching TV and enjoys his time at the home doing jigsaws, knitting and chatting to staff. This resident showed the inspector the new jigsaw he had started and his CD and video collection. One of the residents has some communication difficulties nevertheless it was evident staff had taken steps to ensure his interests were catered for. This resident likes old buses and coaches. The shelves in his room are full of different models of buses and coaches. Staff had also obtained books with pictures of buses, which the resident showed the inspector. Written records contained details of residents’ preferences in respect to their daily routines. Residents said that they could choose what time they got up or 346b Newton Road DS0000005752.V295593.R01.S.doc Version 5.2 Page 14 went to bed, and that they could choose how they spent their time. For example one resident spent time in his bedroom listening to music. Staff were observed to respect residents privacy when entering bedrooms and bathrooms. Interactions between staff and residents were observed to be frequent and friendly. During the course of the inspection staff were observed spending quality one to one time with residents. Most residents said kept in contact with family and friends. Staff members said that relatives and friends were welcome to visit the home at any time. Feedback in returned relative/visitor comment cards confirmed staff were always welcoming. Staff speak with residents on a one to one basis about relationships and other issues. Records of meals served demonstrated meals are varied and tailored to meet resident’s needs and preferences. There are no set mealtimes and depended upon what time people got up or any activities residents were doing. Staff spoken with indicated a sufficient budget was available. Healthy eating is encouraged and at least one cooked meal is provided each day. A good variety of fresh fruit, vegetables and meat were in stock. Residents are offered a choice of meals. For example at both breakfast and lunch each resident chose a different option. Menus are discussed on a one to one basis and in residents meetings. Residents spoken with said that they enjoyed meals and that they got enough to eat. They also said that they had suppers, and snacks and drinks throughout the day. 346b Newton Road DS0000005752.V295593.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this area is good. This judgement has been made from the evidence gathered both during and before the visit to the service. Residents are assisted to be as independent as possible, and they are included in decisions about how staff will support them. Residents’ physical health was promoted and maintained through regular monitoring and health care checks. EVIDENCE: One of the aims of the service was to assist residents to be as independent as possible. Staff were observed encouraging residents to do as much as they could for themselves. Assessments and care plans contain a lot of information about resident’s preferences and chosen lifestyle. All three residents have lived at the home for many years and staff are fully aware of their needs and how each individual prefers to be assisted with personal care. For example one resident sometimes displays challenging behaviour. It was evident staff know how to manage this and were able to calm and divert the resident before things escalated. 346b Newton Road DS0000005752.V295593.R01.S.doc Version 5.2 Page 16 Staff members gave examples of how privacy and dignity were promoted in the home, for instance attending to personal care behind closed doors knocking on bedroom doors, and not discussing residents’ personal information in front of others, or outside the home. It was clear, from discussions with residents that they had choice about their daily routines, for example what time they got up and meal choices. On arrival the inspector observed residents getting up at various times, while at lunch residents had three different meal options. Residents and staff were observed speaking with each other in a natural and friendly manner. Residents said that they were happy with the way that staff members treated them, and the way they spoke to them. One said, “Staff are good”. There was evidence that the resident’s health care needs are regularly monitored. Residents are provided with support to attend regular health care appointments and check ups, details of which are recorded. Evidence of which was observed during the inspection where a resident was supported to attend a hospital outpatient appointment. Prior to the inspection comment cards were sent to external health care professionals in order to ascertain their views. One GP and one district nurse returned comment cards. Neither indicated that there were any concerns regarding healthcare provision in the home. The district nurse wrote, “A very pleasant home to visit”. The home had written guidelines covering medication. Currently none of the residents have been assessed as being able to safely administer their own medication. Medicines were being stored safely, with a clear record of medicines received into the home and any returned to the pharmacist. Medication Administration Records (MAR) were examined and were found to be clear and up to date. None of the residents have been prescribed controlled drugs but a system is in place should the need arise. All staff responsible for administering medication have undertaken training. 346b Newton Road DS0000005752.V295593.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this area is good. This judgement has been made from the evidence gathered both during and before the visit to the service. There is a well publicised and accessible Complaints Procedure with evidence resident’s concerns are listened to and acted upon. Policies, procedures and training were in place to safeguard residents from abuse or harm, and for taking any concerns seriously. EVIDENCE: A detailed complaints procedure is in place. Good practice was noted in that the procedure is available in different formats, for example an audiotape explaining the procedure. The contact details of a member of the Head Office staff are provided so that residents can to complain to somebody outside of the home. One of the staff has been designated as the home’s Complaints Coordinator. This member of staff reminds residents of the procedure and how to complain. No formal complaints have been received by the CSCI (Commission for Social Care Inspection) or the home since the last inspection. Those residents who were able to comment had not made a complaint but all indicated they felt able to approach staff with any concerns. They said that they were confident that any complaint would be properly dealt with. None of the relatives who returned comment cards had made a complaint but all indicated they knew whom to approach if they had a concern or complaint. 346b Newton Road DS0000005752.V295593.R01.S.doc Version 5.2 Page 18 An Adult Protection and Prevention of Abuse policy is in place, which incorporates, whistle blowing. The home ensures all staff complete a POVA and CRB (Protection of Vulnerable Adults Register/Criminal Records Bureau) check before they commence work. No recent POVA (Protection of Vulnerable Adults) investigations have taken place. Staff spoken with understood the importance of reporting any allegations or suspicion of abuse. Training in the signs and recognition of abuse is covered during induction and in NVQ training. Good practice was noted in that staff have completed updated protection of vulnerable adults training. Systems were in place to safeguard residents’ finances. 346b Newton Road DS0000005752.V295593.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27 & 30 Quality in this area is good. This judgement has been made from the evidence gathered both during and before the visit to the service. The home is nicely decorated and furnished, providing a homely environment for the residents. However access to the building and garden needs to be improved to ensure these areas area accessible to residents. EVIDENCE: The home is situated in a residential area of Lowton a few miles from Leigh town centre. It is in a residential area, on a main road with local shops and public transport nearby. The home is on one level. The home is nicely decorated and furnished. Communal accommodation comprises of a lounge, kitchen and conservatory/diner. A laundry room and office are also provided. Since the last inspection the bathing facilities have been improved. On the day of the visit the work on the new bathroom had nearly been completed and both residents and staff were looking forward to using it. The bathroom has been extended with a new assisted bath (Parker bath), wheel in shower and tracking 346b Newton Road DS0000005752.V295593.R01.S.doc Version 5.2 Page 20 system installed. This will benefit both residents and staff as the facility is now suitable for transferring residents in wheelchairs. A separate toilet is also provided. Each resident has a single bedroom. Two of the residents showed the inspector their bedrooms. Each of the bedrooms seen was nicely decorated and personalised with personal mementoes, pictures TV and music centre. Lockable storage space is also provided. Residents spoken with indicated were in the main happy with environmental standards in the home. During previous inspections it was noted that access to the building needed to be improved upon. This remains relevant. Residents are unable to use the front door as the ramp is in a poor state of repair. A requirement was made for a ramp to be installed at the conservatory door. This has not yet been addressed. The acting manager advised that this was due to be addressed but no definite date had been set. This needs now needs to be addressed as a priority. It was also noted that the garden areas were difficult for residents in wheelchairs to access. Consideration needs to be given to how this could be improved. The tarmac paths are quite narrow and most of the garden is lawned. This means residents using wheelchairs cannot access the garden. This situation would be improved if hard landscaped and raised flowerbeds provided. The home was clean and odour free. Liquid soap and paper towels were provided for hand washing in the bathroom toilets, and kitchen. The laundry is suitable equipped with a washer and dryer. 346b Newton Road DS0000005752.V295593.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35 Quality in this area is good. This judgement has been made from the evidence gathered both during and before the visit to the service. A comprehensive training programme is in place, which equips staff with the skills, and knowledge to meet residents assessed needs. Recruitment procedures for staff are robust which ensures people living in the home are protected. EVIDENCE: Relationships between staff and residents seemed warm, caring and friendly, with staff demonstrating a good understanding of residents support needs. It was observed that residents had no hesitation in approaching staff members if they wanted to speak to them. Residents spoken with indicated they were satisfied with the care and support provided. Staff turnover at Newton Road is very low with a number of staff having worked at the home for some considerable time. This would indicate staff are well supported and happy in their role. Further evidence of this was highlighted in discussions with staff. All staff spoken with indicated they enjoyed working at the home and said they worked well as a team. Staff spoken with all 346b Newton Road DS0000005752.V295593.R01.S.doc Version 5.2 Page 22 demonstrated commitment to the residents and a clear understanding of their role. A comprehensive staff development programme is in place and records of training are maintained. There was evidence that new staff undertake induction training that meets the National Training Organisation (NTO) specifications following which foundation training is undertaken. Samples of training records were examined. The records confirmed the wide range of courses that staff had attended and that ongoing training is available. Staff spoken with were happy with the range of training provided by the home. Mandatory training needs are well met. Recent courses include moving and handling, first aid, medication, food hygiene, health and safety and protection of vulnerable adults. Training records also show staff have undertaken a range of more specialised training, including challenging behaviour, leadership training, appraisals, assessment and care plans, communication skills, recording skills, bereavement and stress awareness. Of the eleven support staff working at Newton Road three have achieved NVQ (National Vocational Qualification) Level 2/3. A further two staff are currently undertaking training. This commitment to NVQ training needs to be continued to ensure that 50 qualified staff is reached and then maintained. Staff recruitment records are held centrally at Nugent Care head office in Liverpool. The inspector arranged for a sample of staff recruitment records to be examined. The files of two staff employed looked at showed all necessary recruitment checks had been undertaken. All contained: written application forms, 3 references, Criminal Records Bureau (CRB) check and verification of identification. Good practice was noted in that any gaps of employment and the reasons for leaving previous jobs had been explored. Good practice was noted in that one of the residents living at the home is involved in recruiting new staff. 346b Newton Road DS0000005752.V295593.R01.S.doc Version 5.2 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in this area is good. This judgement has been made from the evidence gathered both during and before the visit to the service. The registered manager is on long-term sick leave. However, this was being well managed, with clarity and stability being maintained. The home reviews aspects of its performance through a programme of selfreview and consultations, which include seeking the views of residents and staff, but relatives need to be consulted on a more formal basis. In the main the health, safety and welfare of residents and staff are promoted and protected. However some shortfalls were identified which need to be addressed in order to minimise the risk to all parties. EVIDENCE: The registered manager is currently on long-term sick leave. It is expected that she will return in approximately three months. An experienced senior support worker has been appointed as ‘Acting Manager’ to cover until the 346b Newton Road DS0000005752.V295593.R01.S.doc Version 5.2 Page 24 manager returns. The Acting Manager has worked at Newton Road for several years and is very experienced. Support is provided from Head Office through regular visits and telephone contact to the home. The Inspector was satisfied with these temporary arrangements. The acting manager advised the registered manager has now achieved NVQ level 4. As the manager wasn’t present it could not be confirmed she had completed the additional units required to obtain the NVQ level 4 registered managers award. Information regarding this issue should be forwarded to the CSCI. It was clear, from observations and discussions, that the acting manager encouraged an open, inclusive atmosphere within the home. During the inspection, it was observed that residents and staff had no hesitation in approaching her if they had anything they wished to discuss. Internal and external quality assurance systems are in place. Regular resident and staff meetings take place and are minuted. Nugent Care representatives visit the home on a monthly basis to audit records and speak to residents and staff. A written report is then produced of the findings. In addition Nugent Care Quality Assurance Team also carries out medication checks and audits. The home has a system for recording the complaints of those who don’t wish to complain formally. Feedback from residents spoken with and in returned resident/relative comment cards indicated staff listened to and acted on what they said. During the last inspection the inspector suggested the home arranged an annual meeting is held with residents and any family members, where issues relating to satisfaction with care and the service in general can be discussed formally and recorded. Another means of obtaining feedback would be to send satisfaction surveys. While it as acknowledged relatives are consulted informally a more formal process (meeting or satisfaction surveys) should be considered. With the pre-inspection materials, the manager provided a list of maintenance and associated records. A number were checked on the site visit on the 18th July, including the gas, and electric appliance servicing. All were up to date. Fire safety records showed that that all fire tests and maintenance procedures had been undertaken regularly. Records also indicated that fire drills had taken place at frequent intervals. It was however noted that the fire risk assessment needed to be updated. Staff completed fire safety training in May 2005. This is now overdue and refresher training needs to be arranged. Training records indicated that training and regular updates are provided to staff in key areas such as moving and handling, first aid etc. 346b Newton Road DS0000005752.V295593.R01.S.doc Version 5.2 Page 25 There were satisfactory policies and procedures in place relating to the recording and reporting of accidents to residents and staff. Samples of accident records were examined and were found to be appropriately maintained. 346b Newton Road DS0000005752.V295593.R01.S.doc Version 5.2 Page 26 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for 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 3 26 3 27 3 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 X 12 2 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 2 X 2 X X 2 X 346b Newton Road DS0000005752.V295593.R01.S.doc Version 5.2 Page 27 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA24 Regulation 23 Requirement To ensure the home is accessible a ramp must be installed at the conservatory door. Timescale 31/12/05 not met. The ongoing programme of staff training must continue so that at least 50 are in receipt of NVQ level 2. Confirmation that the manager has obtained the NVQ Level 4 registered managers award must be forwarded to the CSCI in the timescale indicated. The fire risk assessment must be reviewed annually. Updated fire safety training must be arranged. Timescale for action 30/09/06 2. YA32 18 31/01/07 3. YA38 10 31/08/06 4. 5. YA42 YA42 13,16,23 18 31/08/06 30/09/06 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 YA12 Good Practice Recommendations Opportunities for the younger resident to access employment and educational services should continue to DS0000005752.V295593.R01.S.doc Version 5.2 Page 28 346b Newton Road 2. 3 YA24 YA37 be explored and offered. To improve access for residents to the garden consideration should be given to “hard” landscaping parts and to providing raised flowerbeds. To provide further evidence resident’s relatives are consulted about the service provided consideration should be given to sending satisfaction surveys (annually) or organising a meeting where satisfaction issues can be discussed. 346b Newton Road DS0000005752.V295593.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Bolton, Bury, Rochdale and Wigan Office Turton Suite Paragon Business Park Chorley New Road Horwich, Bolton BL6 6HG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI 346b Newton Road DS0000005752.V295593.R01.S.doc Version 5.2 Page 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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