Inspection on 20/08/07 for 40 Cooperative Street

This inspection was carried out on 20th August 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

40 Cooperative Street 21/10/08

40 Cooperative Street 05/02/07

40 Cooperative Street 12/12/05

40 Cooperative Street 28/07/05

40 Cooperative Street 28/02/05

40 Cooperative Street 03/08/04

40 Cooperative Street 21/02/04

40 Cooperative Street 09/10/03

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

CARE HOME ADULTS 18-65 40 Cooperative Street Stafford Staffordshire ST16 3DA Lead Inspector Mr Berwyn Babb Key Unannounced Inspection 20th August 2007 10:30 40 Cooperative Street DS0000032165.V345205.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 40 Cooperative Street DS0000032165.V345205.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. 40 Cooperative Street DS0000032165.V345205.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 40 Cooperative Street Address Stafford Staffordshire ST16 3DA 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) 01785 252645 F/P 01785 245903 kwebb@staffordshire.gov.uk Staffordshire County Council, Social Care and Health Directorate Care Home 13 Category(ies) of Dementia (4), Learning disability (13), Learning registration, with number disability over 65 years of age (1), Mental of places disorder, excluding learning disability or dementia (3), Physical disability (5) 40 Cooperative Street DS0000032165.V345205.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 5th February 2007 Brief Description of the Service: 40 Co-operative street is located in a residential area of Stafford. Close to the town centre, it is well situated for access and public transport. The unit is registered for 13 adults who have learning disabilities and complex needs. The service provides a high standard of support to individuals who exhibit behaviours that are challenging. The residential provision is divided into three elements. A ground floor provision for 3 residents, A first floor provision for up to 8, And a two-bedded house in the grounds of the main house. The home provides a good standard of accommodation, décor is well maintained throughout. There are two communal lounges on the first floor and one on the ground floor. These offer space for residents and opportunities for staff to facilitate work with small groups or 1 to 1. Services provided include laundry, catering and domestic services and the home has its own day care facility on the ground floor. Number 40 A is a three bedded detached house containing a dining lounge, kitchen, storage covered, hallway, and toilet on the ground floor, and three bedrooms, one of which is used for a member of staff to sleep in , a bathroom, and a landing. This part of the service was not visited during this inspection, but had been deemed satisfactory at the previous inspection. 40 Cooperative Street DS0000032165.V345205.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was undertaken by one person during Monday the 20th of August 2007, and was divided into two separate three-hour portions, one in the morning, and one in the afternoon. It was known prior to the inspection thats the previous care manager had been promoted, and the person in charge of the home at this time was the registered manager of another home belonging to the same proprietors, and one where she continues to be giving management support two days per week, whilst dedicating three days per week to 40 Cooperative St. It was discussed with her that there is no period of grace in the legislation, and that the home is required to have its own person who has been registered as fit to be the manager, and that it would not be acceptable for her to be manager of two homes, especially as the other one is in the far south of the county. She understood that a requirement would be made in this report, and undertook to discuss this with her line manager to expedite an application from the providers for the registration of a manager for this home. Information was obtained for this report through discussion with herself, through a formal interview with a member of the care staff, through observations made during an inspection of the interior of the environment, from a cursory visual examination of the exterior, through discussion with the cook on duty, through the examination of records and rotas, and a review of a sample Of the Person Centred Plans relating to the care of individuals in the home, and of policies, procedures, and records of such things as the process of appointing a new member of staff, the cleaning schedules for different parts of the home, the regular fire prevention testing, the training and qualification records of members of staff, and the menu of alternative meals that were offered during a two-week period. Interaction took place with two of the residents, and one of them was at pains to be positive, as befits his recognised higher level of social and communicative skills, in relation to other people using this service. Staff were observed using de-escalation techniques to retain levels of behaviour that would otherwise have compromised peoples dignity, or pose a risk to others, and their obvious knowledge in interpreting both verbal and non-verbal expressions, contributed to the smooth running of the home. Two bedrooms were observed, and they, like the rest of the home, were decorated and furnished to maximise the feeling of space and brightness. In one bedroom the flooring had been adapted in a creative way to overcome a medical condition. 40 Cooperative Street DS0000032165.V345205.R01.S.doc Version 5.2 Page 6 The inspector sampled the lunch that was going to be served, and this was appetising and nutritious, with an alternative (also cooked) to provide choice to those people who use the service. Staff were concerned about the future of the service, as the local authority who owns this home are currently undertaking a consultation procedure regarding the sustainability of all its directly provided services, and it was reported that this is also causing stress to relatives who are said to be worried about the effects of any upheaval or move, for those residing in the home. A particular concern to the acting manager was the likelihood of this affecting her ability to obtain the level of permanent staff, that is so important in the continuity of the lives of people who use this service. The home was clean and warm, and, with the exception of the laundry that will be mentioned in the text, tidy and well ordered internally, through the garden appeared very neglected and in need of tender loving care. Those people who live there had good-quality clothing, furniture, fixtures, fittings, and were being cared for by a staff group dedicated to their integrity, welfare, and dignity. Current cost of accommodation was given as a single rate of £1687 per week. The only extra charges were for personal choice items such as hairdressing [other than general grooming], and such things as sweets, toiletries, and newspapers or magazines. What the service does well: What has improved since the last inspection? The Web-Cam referred to in a recommendation of the last report has now been purchased, and has been set up to give secure communication between one of the people who use this service and their parent in America. 40 Cooperative Street DS0000032165.V345205.R01.S.doc Version 5.2 Page 7 A new type of flooring has been provided for one person to improve the quality of life and assist with their dignity. Creative use of the available space to provide separate places for some individuals to take their meals has resulted in them having an improved dietary condition, and in a lowering of the tension between themselves and others at meal times. In the case of two people who use this service who now eat together in a room upstairs, it was reported that there has been a marked improvement in their level of independence, and a decrease in their dependency on staff. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. 40 Cooperative Street DS0000032165.V345205.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 40 Cooperative Street DS0000032165.V345205.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, 4, and 5. The quality outcome for the group of people use this service was good. This judgment was made using all available evidence including that gathered during a visit to the service. People use this service have only been admitted after a proper and appropriate assessment has confirmed the ability of the home to meet their needs and known choices. They all have individual contracts drawn up between themselves and the home outlining those aspects required in the legislation. EVIDENCE: Whilst reviewing the sample of the Persons Centred Care Plans, it was identified that whilst the master copy of the statement of purpose had been amended to reflect recent changes (including information relating to CSCI and the promotion of the former registered care manager), those in the individual files had not been. The acting care manager undertook to ensure that this would be done before the end of the week. There had been no new admissions since the last inspection, at which time it had been demonstrated from a detailed review to care plans, that not only was a full and proper assessment of needs and known choices made prior to the admission of those individuals to the service, but that continuous reviews were taking place to keep up with their changing needs and choices. 40 Cooperative Street DS0000032165.V345205.R01.S.doc Version 5.2 Page 10 In the same sample, individual contracts detailing the terms and conditions between the home and the person using the service were observed, and these covered all items laid down in the legislation as being necessary. 40 Cooperative Street DS0000032165.V345205.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, 8, 9, and 10. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People who use this service had their assessed and changing needs recorded in an individual care plan, which included decisions they make about how they lived, how theyd been consulted on, and participate in, all aspects of their lives, risks they were supported to take as part of an independent lifestyle, and their right to confidentiality. EVIDENCE: A sample of the Persons Centred care Plans of people to use this service was reviewed. They were found to start with a page that referred to the ownership of the document by the individual to whom they referred, and to use copious pictures to make it more accessible to them. 40 Cooperative Street DS0000032165.V345205.R01.S.doc Version 5.2 Page 12 A copy of the contract between the home and the individual was followed by a record of the various review meetings that had taken place, covering such things as access to the community, health issue, statutory general reviews, social stimulation, personal choice, assessment of needs, any changes since the last review had taken place, and input by relatives including evidence of links with the advisory service Assist. There was a 24-hour support plan to enable staff to assist that person to look after themself. In addition to the lists of needs and choices, there was a reminder to staff of the dependency of a person using the service on routine, to reduce their anxiety level. Different details of this were recorded for access to the community, as well as when in the home, and covered the whole 24-hour period. Within the module on personal development that was a section on what someone living in the home should expect as they got older, followed by a module on the complaints procedure and how to access it, and a list of any rules and restrictions that had to be imposed due to environmental dangers, such as the kitchen area, or unaccompanied access to the external environment. In a full section on medication, one plan also included methods of addressing the persons periodic objection to taking medications. It had been recorded that one person did not wish to exercise the right to vote. The same persons care plan noted the benefits of pictorial aids, and the use of Makaton to improve communication. This was allied with instructions to staff always to give positive reinforcement and praise in order to maximise selfesteem, and they were instructed always to read and then sign that they had understood what was in the communication passport. There were examples given to staff of decisions that a person would be able to make in their life, and instructions to use these to maximise that persons choices. This was followed by a record of trips out, and the benefit of enhancing their choice in what to wear, as well as the pleasure derived from purchasing Christmas presents, and exercising personal input into what foods were purchased, and ultimately what meals were provided. Later in the care plan this persons love of cooking was recorded. The module on anger management stressed the importance of maintaining the dignity of the individual, and reminded staff of the techniques they had been taught for the management of actual and potential aggression. There were also informative suggestions on how to direct and redirect the destructive behaviour of one person. 40 Cooperative Street DS0000032165.V345205.R01.S.doc Version 5.2 Page 13 Particularly encouraging were the details of the experiences of social interaction of the people using this service, together with a list of where assistance may be required to enable these to be fulfilled. Risk assessments abounded, relating to the individual (and often serious) health care needs of the people being cared for in this service, and in relation to their ability to undertake decisions affecting their choice. The contents of these care plans were all recorded in a clear and concise and informative manner, and had been regularly reviewed with records of any changes made, and of any goals achieved. 40 Cooperative Street DS0000032165.V345205.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): 11, 12, 13, 15, 16, and 17. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People who use this service received extensive assistance to help them maximise the opportunities for their personal development, to take place in appropriate activities, to access the local community to keep contact with family and friends, (or be represented by an appropriate advocate), to have their rights respected, and to enjoy a nutritious and healthy diet influenced by their personal choice. EVIDENCE: Examples given to the inspector of the opportunities that people had for personal development included one gentleman who uses a full-size tricycle to access the town via the dedicated cycle track that runs close to the home, in addition to the usual visits to local pubs and shops, and the particular favourite of one person, to walk on the marshes. (A local conservation area made accessible to the public) 40 Cooperative Street DS0000032165.V345205.R01.S.doc Version 5.2 Page 15 People were maintaining their level of education through courses at Rodbaston and Stafford Colleges, and engaged in community and living skills courses, with one person being on Cannock Chase during part of this inspection, learning more about tree management. Family and friendship ties were evidenced through discussion and review of care plans, and it was learned one person sees his sister every week, whilst another regularly speaks to a friend on the telephone, and a third person spends time at home with mother, and as part of a program to enhance this experience, the family are providing transport in one direction, whilst the home cover the outward journeys. It was discussed that advocacy service were being involved to ensure that peoples rights and responsibilities were recognised and respected during the consultation process about the future of the home, and a meeting had been arranged to involve relatives and try and reduce their concern by keeping them as up-to-date as possible with what is going on. [The date of this is currently fixed as being September 20]. 40 Cooperative Street DS0000032165.V345205.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, and 20. Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. People who use this service were receiving support in a way that most closely matched their preferences, and were the subject of intense input to maximise their physical and emotional health. The recommendation of the previous report concerning the security of the medication Cabinet had not been met and this could lead to problems in maintaining essential medication regimes in case of theft. EVIDENCE: In the sample of care plans referred to earlier, there were a raft of appropriate details of how the assessed and emerging needs of the people who use this service were being met. The majority of people in this home remain under the overall health mentor ship of a Learning Disability Consultant Psychiatrist, and both their regular, and responsive, visits to that person were recorded, together with those to community nurses, different clinics and health centres, and other appropriate health professionals. 40 Cooperative Street DS0000032165.V345205.R01.S.doc Version 5.2 Page 17 These included speech and language, dietician, psychologists, general practitioner and associated district nurses and community resources, and the tertiary Healthcare input of chiropodists, opticians, dentists, and those specialising in and providing help with sensory and hearing problems. Individual plans identified the limitations and boundaries experienced by some people in receiving care, and contained a summary of the knowledge that had been built up over the long and intensive periods of working with these people, which would be helpful to members of staff in their search to carry out tasks that were essential, in ways that maximised the choice and dignity of the individual concerned. Thus, one persons plans identified an historic concern about physical contact, and a program had been planned to help them experience this in a positive sense. There had been a requirement in the previous report relating to new Best practice advice about the fixing of medication cabinets, and unfortunately nothing had been done concerning this, so there will be a requirement in this report that the home review their policies and procedures to ensure that they conform with the most recent published advice of the Royal Pharmaceutical Society, and its partner bodies. 40 Cooperative Street DS0000032165.V345205.R01.S.doc Version 5.2 Page 18 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. This judgement has been made using available evidence including a visit to this service. People who use this service were being protected by the policies and procedures of the home, and by the ethos of staff working. It has been recorded earlier in this report that appropriate and recognised advocacy services were accessed to protect their rights during the consultation process currently being undertaken. EVIDENCE: A member of staff was engaged in a formal interview during which intensive discussion took place over the twin subjects of: The protection of vulnerable adults, and [2], their access to a real and meaningful complaints procedure. He confirmed that, together with all the staff in the home, he had received initial, [and was scheduled for refresher], training in the management of actual and potential aggression, and that they had all undertaken abuse training, and been required to read and make themselves familiar with the policies and procedures of the home. He was aware that anybody who came into contact with a resident of the home could potentially abuse them, and felt that anything that challenge their dignity, their respect, or their individuality would be a form of abuse, which if suspected, must be reported to the person in charge of the home at that time. He felt certain that anybody who was currently employed in the role of carer in this home had the same ethics and beliefs in the primacy of protecting those vulnerable people who used the service. During the previous 12 months only one complaint had been made to the home and this had been dealt with appropriately by their internal procedures. 40 Cooperative Street DS0000032165.V345205.R01.S.doc Version 5.2 Page 19 40 Cooperative Street DS0000032165.V345205.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, 25, 27, 28, and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use this service live in a comfortable and Homely environment, and one that is maintained to be safe and to meet their needs and lifestyles, whilst at the same time promoting their independence. Toilets are large enough to provide privacy for even the most cumbersome mechanical wheelchairs, and there is a range of bathing facilities. With the exception of clutter on the laundry floor, the home was clean and tidy throughout, well decorated, and without any hint of malodours. EVIDENCE: A full tour of the internal environment was made, coupled with a cursory visual examination of the exterior of the building. As a result of this will be a recommendation that further handyman/gardener hours should be obtained in order to enable people to use this service better kept surroundings to their home and those observed at this inspection. 40 Cooperative Street DS0000032165.V345205.R01.S.doc Version 5.2 Page 21 The sensory garden and other areas equipped from the Prince’s Trust grant some years ago, were looking particularly neglected, and discussion with the person acting as manager was extremely supportive of the work being done by the current handyman/gardener, but felt that there was more than enough work in a home of this size, for a full time post. Internally the home was pleasantly decorated giving a light and airy aspect, and furnishings and fixtures were being replaced and renewed where necessary, in order to maintain a good standard. Now that day services do not take place within this building, there is sufficient space to be creative, and this was reflected in being able to provide different areas for individual residents to take their meals, something that was said to have reduced levels of conflict most encouragingly. The Person in charge expressed the view that if the current consultation process identified a future for this site, then much more could be done with some of that space, to further improve the quality of life for the people using this service. With the exception of the laundry, where the high standard of that area was compromised by an excessively untidy and cluttered floor space that presented a health and safety hazard to staff using the area, the home was extremely tidy and well ordered throughout. Individual bedrooms seen by the inspector were comfortably furnished, and considering the challenges presented by some of the behaviours present in the home, were a credit to the work being done to preserve the dignity and well-being of those people using this service. A visit to the kitchen found it spotlessly clean, with all the storage areas neatly set out, and good rotation of stocks being managed. The Cook confirmed she had sufficient stocks of crockery and utensils, and those cooking implements seen were not only clean, they were shining. The home was equipped with both assisted Baths, and with showers, and the necessary equipment with invoices and certificates to show that proper servicing had taken place at the regular intervals being advised. The home does not have any bedrooms with ensuite, but has sufficient and appropriate toilets conveniently located around the campus. 40 Cooperative Street DS0000032165.V345205.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 good. This judgement has been made using available evidence including a visit to this service. The people who use this service are assisted to meet their assessed and changing needs and personal choices, by a group of competent and qualified staff, who had been properly recruited, extensively trained, and deployed in sufficient number. EVIDENCE: Information sent to the Commission for Social Care Inspection by the provider showed that for the 13 people permanently resident in this home, there are currently 31 staff [21 female and 10 male] to assist them in meeting their needs and choices. 62 of these have achieved an NVQ level 2 or above, and a further 7 staff are currently working to obtain NVQ level 2 or above. 16 members of staff are employed full-time to assist with care, 14 members of staff are employed part-time to assist with care, and six other people are employed in rolls of a non-care nature, such as administrative, domestic, cooking, and handyman. In the week prior to this information being made available, 867 care staff hours had been provided for the personal care of the 13 people and use this service. 40 Cooperative Street DS0000032165.V345205.R01.S.doc Version 5.2 Page 23 A formal interview was undertaken with a member of care staff, and in response to questioning, he confirmed that during the process of his employment, all the necessary equal opportunities legislation had been met, and that measures had been taken [such as requiring police clearance and written references and interviews and formal application forms], to ensure the protection of the vulnerable adults he was going to come into contact with. He gave a clear account of the rigorous induction procedure to which he had undertaken, and of the open and accessible supervision measures that he had enjoyed since commencing to work in the home. He outlined all the mandatory training elements that he had received so far, and confirmed that a record was kept of dates when these would need to be renewed, and that from discussion with other staff in the home, he was aware that the continuity of staff training was very important to the home in order to ensure the health and safety of its employees, and a high level of service to those people, who through no fault of their own, exhibited high levels of challenging behaviour. The record show that all current staff had received training in the prevention of infection and management of infection control, and that the managers had been trained in the administration of insulin, in addition to general training in the administration of medications, and the management of actual or potential aggression. 40 Cooperative Street DS0000032165.V345205.R01.S.doc Version 5.2 Page 24 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, 39, and 42. Quality in this outcome area is Adequate. This judgement has been made using available evidence including a visit to this service. People who use this service were benefiting from a well run home, with interim procedures in place to manage the home, but unfortunately, no registered care manager, in contravention of the regulations. There was evidence that their views were being obtained, and that measures were being taken to ensure the health and safety, though unfortunately a lapse was identified in meeting the health and safety of members of staff needing to use the laundry. EVIDENCE: The person in charge of the home at the time of this inspection was not registered to manage this service, and was in fact the registered manager of another service run by Staffordshire County Council Social Services. 40 Cooperative Street DS0000032165.V345205.R01.S.doc Version 5.2 Page 25 It was discussed with her that the providers were legally obliged to have a manager who have been registered with the Commission for Social Care Inspection as a fit person to be in charge of that home, and of that home alone. She undertook to bring this to the attention of her superiors, and understood that this would be made a requirement of this report. The dataset made available by the providers lists various measures by which they canvass the views of people who use this service and their families and supporters, in order to ensure that their voices are heard in the review and development of the home. Currently they are going through a consultation process regarding the future of all directly provided services, and evidence was shown of the involvement of a professional advocacy service to assist the people in the home and their relatives, in making their voice heard during this process. Confirmation was also made available by the providers that all the necessary servicing and certification of safety had been undertaken on the equipment used in the home, and a review of the documentation regarding measures aimed at reducing the chances of fire, or harm caused by fire, was undertaken during this inspection. Whilst in all other respects the health and safety of all people in this home appeared to be of the highest concern, it was felt that better forward planning should have been undertaken to foresee the chaotic untidiness of the laundry floor, in the absence of the person normally responsible for this, during a period of annual leave. A requirement to that effect has been made at the end of this report. 40 Cooperative Street DS0000032165.V345205.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 3 2 3 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 X 27 3 28 3 29 X 30 4 STAFFING Standard No Score 31 X 32 4 33 3 34 4 35 4 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 4 2 x 2 3 3 X X 3 x 40 Cooperative Street DS0000032165.V345205.R01.S.doc Version 5.2 Page 27 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. one Standard YA20 Regulation 13 (2) Requirement The registered person is required to review their policy on the storage of medication to ensure that it meets with currently recommended best practice. A suitably qualified person must be registered with the Commission for Social Care Inspection to manage this service. Timescale for action 20/09/07 two YA37 8 20/10/07 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 YA24 Good Practice Recommendations The registered provider is recommended to increase the availability of staff to maintain the garden so that the people who use this service can enjoy better surroundings than those observed during this inspection. The registered person is recommended to ensure that forward planning for ongoing staffing input should provide for occasions when individuals charged with the DS0000032165.V345205.R01.S.doc Version 5.2 Page 28 2. YA42 40 Cooperative Street management of any particular aspect of this service are on annual leave, or in the eventuality of their sickness. 40 Cooperative Street DS0000032165.V345205.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Birmingham Office 1st Floor Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ 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 40 Cooperative Street DS0000032165.V345205.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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