Inspection on 01/09/07 for 46a Court Road

This inspection was carried out on 1st September 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 9 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

46a Court Road 26/08/08

46a Court Road 26/09/06

46a Court Road 07/01/06

46a Court Road 09/05/05

46a Court Road 22/02/05

46a Court Road 22/07/04

46a Court Road 05/02/04

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 46a Court Road Kingswood South Glos BS15 9QG Lead Inspector Paula Cordell Key Unannounced Inspection 4 September 2007 09:30 th 46a Court Road DS0000003380.V345018.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 46a Court Road DS0000003380.V345018.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. 46a Court Road DS0000003380.V345018.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 46a Court Road Address Kingswood South Glos BS15 9QG 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 909 5459 0117 970 9301 max@aspectsandmilestones.org.uk admin@aspectsandmilestones.org.uk Aspects and Milestones Trust Christopher Gerald Horgan Care Home 5 Category(ies) of Learning disability (5), Learning disability over registration, with number 65 years of age (5) of places 46a Court Road DS0000003380.V345018.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th March 2007 Brief Description of the Service: 46a Court Road is one of a number of homes operated by Aspects and Milestones Trust. Mr Horgan is the registered manager. The home is registered to provide accommodation and personal care to five residents with learning disabilities aged 18 years and over. The property is situated in Kingswood, five miles from the centre of Bristol. Shops are a few minutes walk from the home. There are local bus services and the home also has its own minibus. Accommodation consists of a main house with four bedrooms. Two bedrooms are situated on the ground floor. There is a purpose built bungalow to the rear of the property that accommodates one resident who is supported to live semiindependently. The fees at the time of publishing this report range from £847-886. 46a Court Road DS0000003380.V345018.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced visit as part of a key inspection. The purpose of the visit was to follow up the requirements from the Key inspection in September 2006 and the random inspection in April 2007. In addition to monitoring the quality of the care provided to the five individuals living at 46 Court Road. There have been no additional visits between April 2007 and this visit. There have been no complaints received about the service. However, Aspects and Milestones Trust have conducted an internal investigation in relation to the management of a health situation in the home. This has meant that the manger has been absent from the home for a period of nine weeks. The Trust has kept the Commission for Social Care Inspection informed of the investigation and the outcome. The manager returned to the home the week prior to this visit. The inspection methods used included record checks, case tracking, a tour of the home and discussion with the manager, four staff, and people who use the service. The home has been sending information in respect of regulation 37 notices of events affecting the well being of the people who use the service. These were used as a focus for the site visit, along with the annual quality assurance selfassessment completed by the home and comments from people who use the service (5), relatives (3) and visiting professionals (5). The visit was conducted over a period of six hours and ended with structured feedback. What the service does well: 46a Court Road has provided a home for the people receiving a service for many years. There is an established group of staff supporting individuals. The service promotes the individuals involvement in their care/life planning and decision making within the home. Individual’s care files were person centred and well written. The Trust provides a rolling programme of training and there is a commitment that has exceeded the national targets to ensure staff have an NVQ in care. 46a Court Road DS0000003380.V345018.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? Individuals have benefited from the kitchen windows and the patio doors being replaced. In addition the conservatory is a more homely place to sit which is free from clutter. There are clear procedures for staff to follow in the event of a person falling at night. Individuals are better protected by clear documentation being in place in relation to their financial contribution to the home’s vehicle. The home must be able to demonstrate that they are meeting the care needs of the resident collectively and individually in relation to the newest individual who has moved to the home. Taking into consideration the age of the other residents, compatibility and the accessibility for the new individual to all parts of the home. As part of this the home must ensure that the staffing is adequate to meet the needs of the individuals. Areas that were monitored at the random inspection and commented on in a letter to the provider after the visit in April included the following areas where the home had improved: Improved storage is now in place for medication. Individuals are better protected by a risk assessment on the bathroom radiator and appropriate remedial work has been undertaken. Flooring in the downstairs bathroom and a specific bedroom has been replaced further ensuring the safety of the individuals living in 46 Court Road. Staff have attended appropriate fire training ensuring the safety of the individuals. Individuals have benefited from regular meetings where they can actively take part in the running of the home and voice their concerns constructively. 46a Court Road DS0000003380.V345018.R01.S.doc Version 5.2 Page 7 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. 46a Court Road DS0000003380.V345018.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 46a Court Road DS0000003380.V345018.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): 1,2,5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Information is in place for individuals to make a decision on whether to move to the home. However, the contract requires further information in relation to the fees and who is responsible for paying them. Individuals can be reassured that their assessed needs will be met. EVIDENCE: The home has a statement of purpose and a service user guide. These have been seen on previous visits to the service and meet with the Care Homes Regulations and the National Minimum Standards. The manager stated that there have been no changes to the service. Four of the five individuals have lived in the home for many years. The last person to move to the home was in the October 2005. It was evident that the home had completed a thorough assessment prior to the individual moving to the home and this had informed the home’s care planning processes. From discussion with the manager and the staff team, feedback from relatives and the individual it was evident that the individual was settling in well and previous anxieties in relation to the placement were being resolved. 46a Court Road DS0000003380.V345018.R01.S.doc Version 5.2 Page 10 There is a significant age difference between one of the individuals and others living in the home. However from discussions with the manager it was evident that the home was striving to meet the diverse needs of the individuals. Individuals had copies of their terms and conditions of occupancy these were signed by the individual and the home’s manager. The terms of conditions included the expectations of the home on shared living and the role and the responsibility of the provider. What was lacking was a breakdown of the cost of the placement and who was responsible for paying and if there were any further contributions required for example contribution towards the home’s vehicle. 46a Court Road DS0000003380.V345018.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 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Individuals have a clear support plan which is person centred. However, these must be kept under review. Individual’s safety is assured through a risk assessment process, which does not curtail people from being independent. EVIDENCE: Care plans were in place for each individual. Information recorded was person centred and contained valuable information to support the individuals living in 46a Court Road. This included what were essential or important to the individual. Key workers (named member of staff supporting a specific person) were completing a monthly review, which included major achievements, leisure and activities, contact with friends and family, health issues and goals for the forthcoming month. These were positively written and evidently person focused and led by the individual. 46a Court Road DS0000003380.V345018.R01.S.doc Version 5.2 Page 12 The manager stated an annual review is completed on the person’s written plan of care involving the individual. However, the National Minimum Standard states that care plans must be reviewed a minimum of six monthly. One person’s care plan was written in November 2006 with documentation stating that a review would take place in November 2007. This must be addressed and where care needs are significantly changing support plans must be reviewed more frequently. Daily records were positively written and some of the individuals were encouraged to write their own account of the events of the day. This is good practice and demonstrated a good level of involvement of the individual. Support plans included information on how to support individuals if they become angry or anxious. Advice had been sought from external professionals complimenting the skills of the staff team. Staff have received training on supporting individuals that can challenge, which explores positive and a person centred approach to responding to the individual. The manager stated that the staff are attending a team building day in September 2007 to explore how individuals can be more involved in the running of the home, increasing both involvement and the individual’s sense of value and self worth. Comprehensive risk assessments were in place to ensure that individuals remain safe. It was evident that these did not curtail individuals from being independent. The manager stated that they were in the process of reviewing the risk assessments systematically and this had been undertaken for 4 of the 5 persons living at 46 Court Road. 46a Court Road DS0000003380.V345018.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): 12,13,1,5,1,6,17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Individuals are encouraged to lead full lifestyles based on choice. Individuals are supported to maintain relationships with relatives and friends. Individuals have a varied diet taking into account their preferences. EVIDENCE: From reading care information including daily diaries, speaking with people who use the service and staff and observations it was evident that there was a great commitment to ensuring that individuals lead full and active lifestyles. One person stated that they go out every day with staff, attend a ceramics class on a Friday and has had a holiday this year. Individuals have support plans that clearly demonstrate that they are supported to access work placements, college courses and resource and 46a Court Road DS0000003380.V345018.R01.S.doc Version 5.2 Page 14 activity centres. The manager stated that some of the day care provision is closing in respect of luncheon clubs and a drop in centre and the team are supporting the two individuals it affects to find alternative activities. From reading the daily diaries individuals have been or are planning an annual holiday and have been on a variety of trips to places of interest. One person stated that they had enjoyed a recent trip to Cheddar and Weston Super Mare and were planning to go to Burnham on Sea. It was evident that the holidays were tailored to the individual. Individuals are consulted regularly about activities at their monthly care reviews and during house meetings. Monthly House meetings were taking place. Discussions included activities, menus, holidays and complaints. Completed surveys from relatives and people who use the service provided evidence that individuals are supported to live the life their chose. Individuals confirmed in the surveys that they are supported to do what they want throughout the day including weekends. Three individuals attend church on a weekly basis as evidenced via records and in conversation with one person, demonstrating a commitment to meeting individuals spiritual needs. One person stated that staff regularly assist them with manicures and painting nails. An aromatherapist on a weekly basis visits one person to assist with relaxation. Feedback from relatives evidenced that they are made to feel welcome and are kept informed of important changes. Contact with relatives was evidently maintained as confirmed in support plans. One relative stated, “staff are dedicated to their roles and treat the individuals with respect”, another stated, “They always observe a good rapport between their relative and staff”. The home has a vehicle to enable individuals to access the community. Individuals contribute part of their disability living allowance to the cost of the vehicle and pay for petrol based on usage. In response to a previous requirement this is clearly documented with consent sought from the individuals on the deduction. Menus were seen and demonstrated that individuals have a varied diet based on choice. Individuals take it in turns to choose the main meal. There were gaps in the recording of food. A member of staff stated the home has used a considerable amount of agency staff recently and it was felt that this may have been why the lunch and the breakfasts may not have been recorded. No requirement was made as reassurances were given that this would improve. 46a Court Road DS0000003380.V345018.R01.S.doc Version 5.2 Page 15 There was a good stock of fresh and convenience food. Shopping was completed weekly involving individuals living in the home. The majority of the staff have attended a course in food hygiene. The manager contacted the training department on the day of the inspection as it was noted that a member of staff’s certificate of food hygiene had expired, a date was arranged for November for this to be updated. This is good practice and demonstrated the commitment of the Trust in ensuring a trained workforce were supporting people who use the service. Systems were in place to ensure that people who receive a service are protected in the preparation and the cooking of food, with clear risk assessments and procedures. Satisfactory records were being maintained of fridge, freezer and cooked food temperatures. 46a Court Road DS0000003380.V345018.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Individual’s health and personal care needs are being met. Individuals are protected by the home’s medication procedures. EVIDENCE: Support plans clearly described how the home was supporting individuals with their personal and health care needs. Again this was person focused. Systems were in place and concerns about health were promptly addressed. Individuals had access to other health professionals including a GP, opticians, dentist and the community learning disability team. Staff have attended training in first aid and manual handling. However, the staff are now due an annual update for manual handling as this had expired in April 2007. As the home experiences a significant number of falls this must be addressed as soon as possible. The Trust has recently completed an investigation into the lack of medical intervention following a fall of an individual. The manager stated that this is 46a Court Road DS0000003380.V345018.R01.S.doc Version 5.2 Page 17 now complete and an action plan has been developed in relation to reporting and recording. Where individuals are prone to falls there are risk assessments and safe working practices in place. However, on the day of the inspection a person fell and the equipment required for assisting had not been charged. This was addressed during the visit with guidelines being developed for staff on the charging of the equipment. Observations of the staff during this health emergency were positive and sensitive to the needs of the individual. Safe manual handling procedures were adopted with the person managing to get up from the floor with the use of a chair. Staff were observed asking and monitoring the individual’s well being throughout the visit with documentation of the event being recorded. Accident records were being maintained and cross-referenced with the diary of events for the people who receive a service. Appropriate action was seen to be taken. The home has recently reported a staff accident in respect of Reporting of Injuries, Diseases and Dangerous Regulations (RIDDOR) as the person had more than three days off from work due to a back injury, it was evident that action was being taken to remove the risk which involved the staff member moving a freezer to access the water stop valve. The home has robust procedures and practices on the administration of medication, including a comprehensive induction and training package for staff. The home addressed a requirement relating to storage as evidenced at the random inspection in April 2007. 46a Court Road DS0000003380.V345018.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): 21,22 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Individuals are supported to raise concerns about the service provided. Individuals are protected in the event of an allegation of abuse by the home’s policies and procedures, however staff must receive training on safeguarding. EVIDENCE: The home has a complaints procedure, which clearly describes how a complaint is responded to. The home’s record of complaints demonstrated that there have been no complaints since the last inspection. Evidence at previous visits is that complaints are responded to appropriately involving senior management in line with the home’s policy. The policies and procedures relating to the Protection of Vulnerable Adults were in place as seen at the last inspection. Staff spoken with during previous visits had a good knowledge of what constitutes abuse and how an allegation of abuse must be responded to. The same staff were working on the day of this visit. Staff stated that this is discussed both through inductions and the Trust organises compulsory training for all staff. Two members of staff have not attended training in protection as evidenced in training records. Staff may benefit from an up date on abuse training as they last attended three years ago. The home has robust procedures on the finances of the home and that belonging to individuals receiving a service. These procedures were translated into practice. Checks are completed on finances on a daily basis by staff and 46a Court Road DS0000003380.V345018.R01.S.doc Version 5.2 Page 19 monthly during the provider visits in respect of regulation 26. Two staff signatures and a receipt supported all expenditure. Individuals where possible had signed the record of financial transactions. Risk assessments were seen detailing the level of support individuals required in respect of their finances. Individuals had varying control in relation to their finances, which was based on the assessment and the abilities of the person. 46a Court Road DS0000003380.V345018.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): 24,27,28,30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Individuals live in a clean and tidy environment. However, safety could be being compromised if minor repairs are not responded to for example the broken step and that the call bell is not accessible in the bathroom. EVIDENCE: 46a Court Road is in a residential area close to local amenities and in keeping with the local neighbourhood. The focus on this inspection was the communal areas. The home has demonstrated compliance to requirements and recommendations from the last inspection to replace windows to the kitchen and to make the conservatory more homely and less cluttered. However, further concerns were raised during this visit which relate to the safety of the step leading to the conservatory which had a crack through the 46a Court Road DS0000003380.V345018.R01.S.doc Version 5.2 Page 21 paving step and was very unsteady. This was reported on the day of the visit and reassurances were given that this would be addressed. Individuals have a lounge, which doubles up as the dining room and a conservatory looking onto a secure and enclosed garden. Staff stated that one of the individuals living in the home has the responsibility of tending to the garden. It was noted that there is a slight odour in the lounge. Staff stated that this is due to the carpet, which although cleaned at regular intervals the slight odour is still apparent. It was noted from records of a visit conducted by the provider in May that they identified that the carpet should be replaced. The manager stated that this will be followed up and addressed. The manager stated that the bathroom is in the process of being refurbished taking into consideration the needs of the individuals. The manager stated that as yet no date has been confirmed but this would be undertaken within this financial year. It was noted that the emergency call bell was not long enough for individuals to use. This must be rectified. The kitchen was clean and tidy. However, peeling paint was noted around the window and by the door. A member of staff stated that they have been given the responsibility to decorate this. A further conversation with the manager confirmed this who stated that the Trust has recently confirmed a budget for the decoration to go ahead and that a carer would be paid as a bank shift so as not to impact on care hours. No requirement was made at this visit as evidence was provided it was going to be addressed. Bedrooms seen at the last visit were personalised and homely and reflected the taste of the individual. Keys are available for the occupants. A member of staff stated that rooms are only entered with the express permission of the individual. The home has access to a team of maintenance contractors with a good response to repairs. 46a Court Road DS0000003380.V345018.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 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Adequate staff support the individuals living at 46 Court Road. Shortfalls in the staff training could put individuals potentially at risk of harm in relation to the lack of protection and health and safety training for some staff members. EVIDENCE: The home is adequately staffed with two staff working in the home throughout the day and the evening with one member of staff providing sleep in cover at night. This was evidenced in conversations with staff, the manager and daily dairies of activities of the people who use the service. The manager stated that there has been a slight increase in staffing in that the home is now staffed every shift with two staff. Whereas before, the second staff may have covered both the early and the late by working 11 to 7 shift. This was in response to concerns raised by staff in the event of health emergencies including falls. This must continue to ensure the safety of the people using the service. 46a Court Road DS0000003380.V345018.R01.S.doc Version 5.2 Page 23 In addition the home provides a third member of staff during the day to support the fifth person who lives in a self contained flat in the garden of 46 Court Road. Staff, the manager and the completed annual quality assurance assessment provided evidence that the home has had a high amount of bank and agency support in the last three months. Bank and Agency, on average have covered approximately 200 hours per month during this period. The manager stated he and two members of staff have been absent for that period of time. Staff described a period of unsettlement and low morale during this period. However it was evident that this was changing now that the two staff and the manager have returned to work and there was more stability within the team. Recruitment information was not seen on this occasion, as there have been no new members of staff. However the inspector is aware that this is now being kept in the home in accordance with the legislation, as previously this was kept in the main office for Milestones and Aspects. There are policies and procedures in place to ensure that a thorough recruitment process takes place. It was evident from records and conversations with staff that there were good support mechanisms in place including regular staff meetings and daily handovers and supervisions. However, the manager stated that staff meetings have not been regular due to the period that he had not been working in the home. It was evident that this was being rectified with a team-building day being arranged for the end of September. The manager stated staff meetings would then continue every four to six weeks. From reviewing staff training records it was evident that little training had been completed during the year of 2007. It was noted that all staff were now due for an update in manual handling, one member of staff’s food hygiene certificate had expired and two staff had not attended a course on protection of vulnerable adults. The National Minimum Standards recommends that staff attend at least five training days per annum. The training records provided evidence that in the past staff had attended a wide range of topics relevant to the care of the people living in 46 Court Road. Staff complete the Learning Disability Award Framework as part of their induction. This was not viewed on this occasion as all staff had been working in the home in excess of twelve months. The annual quality assurance assessment completed by the provider provided evidence that the home has exceeded the target for 50 of the staff team to have an NVQ in care. Seven of the eight staff have completed an NVQ in care. This is commendable. Staff had clear guidelines on their roles as key worker and each member of staff had been delegated a specific role in the home. This is good practice. 46a Court Road DS0000003380.V345018.R01.S.doc Version 5.2 Page 24 Staff spoken with during this site visit had a good understanding of the care needs of the people receiving a care service. 46a Court Road DS0000003380.V345018.R01.S.doc Version 5.2 Page 25 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Individuals can be confident that the home is managed well. Individual’s safety could be compromised due to the lack of training in health and safety relating to manual handling. EVIDENCE: Mr Chris Horgan is the registered manager. He has worked for the trust for many years supporting individuals with a learning disability. He is a registered nurse. The home has been through an unsettling period with the manager being absent from the home for a period of three months. During this period a registered manager from another home supported 46 Court Road with the area 46a Court Road DS0000003380.V345018.R01.S.doc Version 5.2 Page 26 manager visiting on a regular basis. The Trust completed an investigation during this period into a situation that occurred in the home relating to an individual that fell. The Trust has kept the Commission for Social Care Inspection informed of the ongoing investigation and the management arrangements for the home. Relationships observed between people who use the service, the staff and the manager demonstrated that these were positive. People who use the service spoke highly of the manager and the staff team. Staff stated that the manager has an open door and hands on approach to the care and management of the home. Policies and procedures are in place to ensure the health and safety of the people who use the service and staff members. These form part of the induction. The home has good systems for monitoring the quality of the care provided to the individuals living at 46 Court Road. These included monthly key worker meetings with people who use the service, house meetings, supervisions, staff meetings and a quality assurance tool, which encompasses the Care Homes National Minimum Standards. The latter was not fully explored on this occasion. Regulation 26 monthly provider checks were taking place and copies of the report were sent to the Commission for Social Care Inspection along with any notification of incidents that affect the wellbeing of the individuals living at 46 Court Road in respect of Regulation 37. There were systems in place for ensuring that the home was a safe place to live and work. All records relating to fire, including ongoing training for permanent staff, were up to date and in order. However, two staff had not attended a fire drill as recommended by the fire officer. Other areas of concern were lack of annual updates in manual handling as this was due in April 2007. The manager was aware and stated that he was in the process of arranging this training before his leave of absence and was in contact with the Trust’s manual handling trainer. 46a Court Road DS0000003380.V345018.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 X 4 X 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 2 X 46a Court Road DS0000003380.V345018.R01.S.doc Version 5.2 Page 28 No 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 YA5 Regulation 5 (2) (a) Requirement Expand contracts for people who use the service to include information relating to Regulation 5a, which includes a full breakdown of fees and who is responsible for paying them. For people who use the service to have a copy of their contract and this to be signed by the individual where possible and other appropriate persons. The contract must include what is included in the fees and any additional costs. For care plans to be kept under review a minimum of six monthly. Replace or make safe the broken step in garden leading to conservatory. Ensure all call bells are accessible including in the bathroom. Ensure all areas are free from odour. Clean or replace carpet in the lounge. For staff to have training in protection of abuse and this must be kept under review. DS0000003380.V345018.R01.S.doc Timescale for action 04/09/07 2. 3. 4. 5. 6. YA6 YA24 YA24 YA30 YA23 15 (2) (b) 23 (2) (b) 23 (2) (n) 23 (2) (d) 13 (6) 04/11/07 11/09/07 11/09/07 11/10/07 04/12/07 46a Court Road Version 5.2 Page 29 7. 8. YA35 YA35 13 (5) 18 (1) (c) (i) 18 (1) (C) 9. YA42 23 (4) (e) Staff must attend training in manual handling Staff must attend training relevant to their role and a training plan must be made available for the team collectively and as individuals. All staff must attend a fire drill once in a six-month period. 04/10/07 04/11/07 11/09/07 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. 2. Refer to Standard YA35 YA35 Good Practice Recommendations For care staff to attend at least 5 days training per annum (pro-rata for part time staff) For the home to audit training and have an overview of staff statutory training detailing when completed and when next due. 46a Court Road DS0000003380.V345018.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection South West Regional Office 4th Floor, Colston 33 33 Colston Avenue Bristol BS1 4UA 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 46a Court Road DS0000003380.V345018.R01.S.doc Version 5.2 Page 31 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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