Inspection on 07/06/05 for 49 King Street

This inspection was carried out on 7th June 2005.

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

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

49 King Street 15/03/07

49 King Street 28/11/05

49 King Street 18/01/05

49 King Street 14/07/04

49 King Street 17/02/04

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

The Cornerstone

John Street Nursing Home

Pennine Camphill

Whitwood House

Whitwood Hall

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

CARE HOME ADULTS 18-65 49 KING STREET Thorne Doncaster South Yorkshire DN8 5AU Lead Inspector Mike Hamstead Unannounced 07 June 2005 08.00am. 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 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 Stationary 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. 49 KING STREET CS0000044366.V182808.R01.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service 49 King Street Address Thorne Doncaster South Yorkshire DN8 5AU 01405 818580 01405 743110 christine.hobson@hesleygroup.co.uk Hesley Lifecare Services Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Christine Hobson PC Care Home only 6 Category(ies) of LD Learning Disability 6 registration, with number of places 49 KING STREET CS0000044366.V182808.R01.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users aged 16/17 should not be accommodated where there are other service users over the age of 25. Date of last inspection 18 January 2005 Brief Description of the Service: 49 King Street is situated in the market town of Thorne, approximately 11 miles from Doncaster, and is situated in close proximity to the town centre and is close to public transport, shops, supermarket, post office, and health facilities.It is also close to both motorway (M18 and M62) and Thorne railway station, which provides regular access to Doncaster Goole, and surrounding areas. The property comprises a large detached six bedroom house, (ex doctors surgery) with all bedrooms being on the first floor, and containing ensuite facilities.The ground floor facilities comprise of two separate lounges, a large dining room, conservatory, kitchen, cloakroom and utility room, and two activities rooms.The rear of the house includes a large private garden, with a terrace overlooking the lawned grounds, and private car parking, and there is a secure patio area at the front of the building. 49 KING STREET CS0000044366.V182808.R01.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection methodology consisted of interviews with the care manager and all staff on duty, and an examination of the homes records. It also included a tour of the building to observe the accommodation. Additional information of the overall situation had been gained from previous inspection visits. The inspection was commenced at 08:00 and finished at 15:15pm and included talking to members of staff, and those residents that were able to communicate. What the service does well: Obtains an accurate assessment of residents needs including specialist needs, and prepares a plan of care and develops this based upon the experience and changing needs of residents living there. Provides a high standard of accommodation suitable for residents lifestyles and ensures privacy for residents when required. Enables residents to be involved in the day to day running of the home, and to be involved in decision making to the level of their capabilities. Provides a flexible approach to daily living activities and proceeds at the residents own pace with lots of opportunities for residents to become involved in the local community. A range of both vocational opportunities and leisure pursuits are available for residents to choose from, including an annual holiday. Provides sufficient staff to meet residents needs, and has a comprehensive staff training programme. Ensures that residents views are listened to, and where necessary acts to safeguard their safety at all times. 49 KING STREET CS0000044366.V182808.R01.doc Version 1.30 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. 49 KING STREET CS0000044366.V182808.R01.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection 49 KING STREET CS0000044366.V182808.R01.doc Version 1.30 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 standard(s) 1 2 3 4 & 5 Potential residents/representatives would not have all the information about the home available to them to enable them to understand and decide whether the services the home provides meets their needs because the home has not got a Statement of Purpose. Opportunities are provided for residents/representatives to visit the home prior to admission so that they can familiarise themselves with their potential surroundings and meet other residents and staff before deciding whether they want to live at the home. EVIDENCE: The Statement of Purpose and Service User Guide, have now both been amended to delete all reference to Community Solutions, since responsibility for the overall management of the home was transferred to Hesley Village and College at Tickhill, on the 1st July 2004. It was not possible however to check these documents as the home has not as yet received an amended copy, a problem also encountered at the last inspection in January 2005. The care manager now reports to the Head of Hesley Village and College Sue Ekins, who provides line management and supervision to the care manager. 49 KING STREET CS0000044366.V182808.R01.doc Version 1.30 Page 9 The aims, objectives, and philosophy of the home have not changed ie to provide a placement for residents capable of living in the community as an alternative service to that provided by Hesley Village and College for Hesley Group students leaving their 52 week schools within the group or from admissions from elsewhere outside the group. Care records showed that all residents had received an assessment of their needs, and three of the four residents were transferred from other Hesley establishments. The care manager has learned that she is to be involved in the assessment process in future. The residents needs are met in full by a staff group organised and trained to provide care to the individual requirements of each resident. Specialist psychological, psychiatric and counselling services are sought for residents as required, demonstrating the homes ability to meet residents needs, and the care manager works in liaison with other agencies, e.g. social workers and speech language therapists. All the current residents were invited to visit King Street prior to taking up permanent residence, and all the residents received a structured introduction to the home including trial visits before being permanently admitted. Emergency admissions do not generally take place, as they could disrupt the compatibility and balance of the resident group, but the home accommodated 3 residents temporarily from another Hesley establishment in Lincolnshire earlier this year, following an emergency at that establishment. A contract/ statement of terms and conditions is agreed with the resident/and or their representative so that it is clear what services the resident can expect to receive. There were no 16 and 17 year old residents accommodated at the time of this inspection, so it was not necessary to use the supplementary standards contained in the National Minimum Standards 49 KING STREET CS0000044366.V182808.R01.doc Version 1.30 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 standard(s) 6 7 8 9 & 10 The individual needs and choices of residents are being met demonstrating the availability of an accurate and ongoing assessment of all residents. EVIDENCE: Plans of care were examined and found to be satisfactory. The most recently admitted resident has a plan of care, that will be updated as staff increase their knowledge of his needs. The plans of care are reviewed on a regular basis and progress/ otherwise is recorded. King Street is a small home with a maximum of six residents living there at one time. The extent of the learning difficulties of some of the residents at King Street, makes it difficult for them to make some decisions about their day to day lives without some form of staff assistance and guidance, and where this applies, it is recorded in their plan of care. Only two of the residents are able to communicate their views by speech, a third resident has some speech that requires careful interpretation and uses PECS, and another resident also uses PECS as a method of communication. One resident has a sequencing board and a key ring with symbols on it. 49 KING STREET CS0000044366.V182808.R01.doc Version 1.30 Page 11 The homely and domestic type setting however provides the opportunity to involve residents in the day-to-day running of the home and this is done by inviting them to participate in the domestic routines of keeping the home tidy plus shopping for food and deciding on menus. The care manager/team managers and clinical psychologist with responsibility for residents at 49 King Street also agree a behaviour management strategy for residents, and a specific individual behaviour plan for each resident. This documentation forms a planned strategy to address identified behavioural problems exhibited by individual residents. The plan sets out how specialist requirements will be met via positive planned interventions by trained staff where necessary, which again are reviewed on a regular basis to monitor progress or a change in behaviour. Staff monitor behaviours as requested by the clinical psychologist. Any restrictions agreed concerning the freedom or choice of a resident are agreed in conjunction with all the relevant parties concerned, including care staff, especially the service users key -worker, the clinical psychologist, and care manager, and dependent upon the circumstances is communicated to parents and placing authorities. This situation does not apply to any residents at the present time, who are able to follow a flexible lifestyle to suit themselves. Placement reviews are carried out after 3 months, and then at 6 monthly intervals with the social worker, parents, and where possible resident at which time staff from the 3 discipline areas of care, behaviour, and vocational education, discuss and review the residents involvement and progress during the previous 6 months, and make recommendations for the next 6 months. Staff ensure that risk assessments are in place for all contingencies, both within 49 King Street, and when residents are escorted on external activities including recreational/leisure trips. Staff prepared a risk assessment for an afternoon recreational walk along the canal bank in Thorne, and also for a residents trip to Thorne swimming baths. Individual risk assessments are reviewed on a 6 monthly basis, and amended, based upon knowledge of the particular and changing experiences of many residents Staff are trained to be constantly vigilant throughout their work with residents, and it is the staffs role to attempt to teach the potential dangers to residents, in various situations encountered within the home, and whilst out in the community. There is a policy and procedure on how to deal with any resident that goes missing in order that steps can be taken quickly to ensure their safety. 49 KING STREET CS0000044366.V182808.R01.doc Version 1.30 Page 12 The home has a policy on confidentiality and all the residents records are kept safe and secure. Staff are aware of the kind of information given in confidence by residents that needs to be shared with their managers or others. There is a specific telephone message sheet/other records to record contacts with placing authorities and parents as part of an overall care management system. 49 KING STREET CS0000044366.V182808.R01.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11 12 13 14 15 16 & 17. Residents are able to maintain appropriate and fulfilling lifestyles both in and outside the home. There are opportunities for personal development, education and occupation, and community links are promoted. Regular communal and leisure activities are available, and contact with family and friends is encouraged and maintained to enable residents to engage in appropriate relationships. EVIDENCE: Residents are given opportunities for personal development, and are encouraged to lead ordinary yet meaningful lives appropriate to their peer group. Staff have devised a vocational/activities timetable for all residents, that includes a combination of vocational/life skills/activities at various educational establishments, Doncaster College, and Hesley Village College, as well as inhouse teaching of independent living skills, and access to various commercial outlets for activities and shopping. The home has its own vehicle, but also uses 49 KING STREET CS0000044366.V182808.R01.doc Version 1.30 Page 14 public transport including the train for vocational and community recreational visits to enable residents to experience community involvement. All four of the residents attend Hesley Village College for “drop in sessions”, for such diverse activities as horticulture art and craft, and the female residents have jobs in the Colleges hairdressing and beauty salons on 2 days per week. One resident attends Doncaster College on 4 days per week for an “essential skills” course, and all the residents are attending an “open day” there next week to see if there are any relevant courses available for them. One resident is involved in a conservation group at Fishlake where he meets students from Hesley Village and College and he also attends a gymnasium at Moorlands prison in Doncaster, an activity carried on from his former placement at Fullerton House School. All residents are known in the local community and go for walks into Thorne town centre, where they are known by shopkeepers and market stall holders alike, and this enables them to engage in conversation which enables them to establish links with the wider community. They also take part in shopping trips locally, and assist to pack the shopping bags, and there are trips further afield to Doncaster and Meadowhall. Leisure activities include swimming at a number of venues including Thorne and Goole baths that are used. Visits to pubs are very popular, and residents attend a Men-Cap run youth club in Thorne every Wednesday who organise excursions for them. There are also visits to the cinema, bowling at the Dome, and trips to the coast. The home uses the local canal boat for pleasure trips that are all risk assessed. The care manager is planning a holiday at Center Parcs later this year, and all 4 residents will go to the” Hesley Challenge” at Hesley Village College later this month. All residents enjoy doing their own thing like watching videos, listening to music and reading magazines, usually in their own rooms, and the home has a computer in the activity rooms, which they can use. The home has a weekly music night, involving a keyboard, tambourine and karaoke machine. The home encourages family links and there is a regular interchange of contact and visits by parents to the home and by residents to their families. In the event of any resident developing and maintaining an intimate personal relationship, the home would seek specialist guidance to enable the resident to make appropriate decisions, and the home has got a policy on this. All staff are trained to respect residents privacy and residents have their own keys to their rooms although two residents require staff assistance with this. 49 KING STREET CS0000044366.V182808.R01.doc Version 1.30 Page 15 There is a 4 weekly menu devised with resident input, and staff try to encourage all residents to eat a healthy diet. Breakfast and lunch is usually residents choice, where they help in its preparation, and the main meal is prepared by staff in the evening with resident assistance. The meals are usually taken in the dining room, and there is a regular theme night, where for example Chinese and Indian food is cooked in –house, and all the residents participate in the cooking, preparing the tables, and clearing away and washing the pots after the meal. None of the residents have shown any interest in attending church, but staff would enable any resident to attend if the situation changed, and all residents are on the electoral role, and receive postal votes but none have voted to date. 49 KING STREET CS0000044366.V182808.R01.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 19 20 & 21 The promotion of personal healthcare and specialist support to residents is taken seriously and acted upon to safeguard their interests at all times. EVIDENCE: Residents receive personal support in many aspects of their day to day lives, from assistance with personal hygiene and shopping, to suggestions about their appearance and what clothes to wear, and this is carried out in a manner that protects their privacy and dignity. There is a key-worker system in operation. Rising and retiring times are flexible subject to the requirements of college attendance, and residents can generally plan their day to suit themselves. All residents are registered with a General Practitioner and are able to attend the health centre if necessary, accompanied by staff on these occasions. Residents have some choice of the staff they would like to work with them, but are reminded that circumstances may mean that this is not always possible. 49 KING STREET CS0000044366.V182808.R01.doc Version 1.30 Page 17 All residents have a comprehensive medical file, and there is also medical audit sheet, and their healthcare needs are recorded and form part of their overall assessment of need. The residents immediate healthcare needs are the responsibility of the local General Practitioner who has agreed to take on new residents as they are admitted, and will visit them in the home, or if they are well enough a member of staff will accompany the resident to the surgery. All residents have access to all the other local primary health care facilities, and attend these facilities with staff accompaniment where possible, thereby accessing community services as part of their independent living skills. In addition, the home has access to a clinical psychologist, a visiting psychiatrist at Hesley Village and College and speech and language therapist. Staff are trained to observe and recognise the early warning signs of ill-health in residents, and because of their knowledge are usually able to interpret residents needs to health professionals where they are not able to do it themselves. Residents are offered minimum annual health checks. There have been visits to A&E for one resident with a skin allergy, and another resident with a ligament problem in his foot since the last inspection, both demonstrating a positive and caring approach by staff to residents healthcare needs. None of the residents are able to self medicate, and the MAR sheets were checked and found to be in order. There is a policy and procedure for dealing with the ageing illness and death of a resident to provide a holistic approach to the management of care. 49 KING STREET CS0000044366.V182808.R01.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 & 23 Staff now have a greater knowledge and an understanding of how to identify residents complaints and are to be commended for their willingness to report potential Adult Protection issues to promote the protection of residents. EVIDENCE: There is a complaints record where any complaints can be recorded, together with details of any investigation, action taken, and the outcome, and there have been two complaints recorded since the home the last inspection. Since the last inspection progress has been made by the care manager and staff in actually recognising when legitimate complaints were being made by residents with a learning difficulty, as this had been a problem at previous inspections. There is a written policy on the prevention of abuse in its many forms to residents, and also a whistle blowing procedure, as part of a Child/Adult protection policy and procedure. Links have been established between the home and the Child/ Adult Protection Officers in Doncaster Metropolitan Borough Council (DMBC), and the process agreed by which any incidents of abuse have to be routed to the local authority as part of the Child/ Adult Abuse Prevention Process. Since the last inspection there have been two “causes for concern” reported by staff, that involved inappropriate language being used to residents by staff, one that has been referred to Adult Protection with no decision reached as yet, the other being dealt with as an internal disciplinary measure. Both examples demonstrate the determination of certain staff to follow procedures and report 49 KING STREET CS0000044366.V182808.R01.doc Version 1.30 Page 19 any instance affecting the general welfare of residents in the home and is to be commended. There is a policy and procedure on how to deal with the physical and verbal aggression displayed by residents, and training is given to all staff as part of the home’s Positive Approaches programme of training. This approach is based upon a positive intervention when necessary, and includes the SCIP technique (Strategies for Crisis Intervention and Prevention ) All interventions where any form of restraint has been used are recorded on an incident form, and are checked by the care manager/team managers, to ensure their appropriateness. They are then further analysed by the care manager who analyses them in terms of the residents overall behavioural programmes, and then decides whether or not there needs to be any amendments to the residents particular behavioural plans. There is a policy and procedure for residents monies and financial affairs, which precludes any staff involvement in the making, or benefiting from residents wills. A sample of residents monies was checked and found to be correct. 49 KING STREET CS0000044366.V182808.R01.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24 25 26 27 28 29 & 30 Continuing investment maintains the appearance of the home and creates a homely and comfortable environment for residents visitors and staff. EVIDENCE: 49 King Street was registered in July 2003, and still maintains a very high standard of furniture and fittings, in this relatively small group living situation. All accommodation is single bedroom en – suite accommodation, and in addition to having all en–suite facilities, there is also an additional bathroom and WC and a separate WC. The level of furniture, fixtures and fittings in the bedrooms are appropriate to meet the needs of the individual residents, but not all of the bedrooms have all the furniture necessary to meet this standard, because for some of the residents this would be very difficult for them to cope with. 49 KING STREET CS0000044366.V182808.R01.doc Version 1.30 Page 21 The care manager has assessed the variable tolerance levels of residents to the additional furnishing requirements of this standard, and where it is identified not to be in the residents interests to have additional furniture in their bedrooms, has recorded such omissions in their plan of care. The four residents accommodated have a variety of equipment in their rooms, including television, and facilities for various other items of electrical equipment such as video recorders, play stations, radios, and CD players. One resident has sensory lighting in his bedroom, and another resident has his furniture and equipment securely affixed and protected because of his challenging behaviour in this respect. All bedrooms also have a telephone point connection, and the facility for an internet connection, but are not used at the present time. There is a planned maintenance and renewal programme for the fabric and redecoration of the premises, which is put into operation when required. None of the residents have a physical disability, and the home is accessible to all residents, and the premises generally present as domestic in style. There is also a range of comfortable and accessible shared space, including 2 lounges, a dining room, conservatory, and an activities room. In addition there is a kitchen, reception area, utility room and an office. Externally in the front courtyard, staff have organised a sensory area in an area where residents have planted flowers, and it is planned to plant herbs as well. At the rear of the home, there is a large lawn, together with an orchard and a summer house used by the handyman. Some of the residents assist the handyman with odd jobs in the garden. Staff are aware of the dangers of being next to a busy main road, and residents do not leave the building from the front. Additional security measures have been installed on one of the front gates to safeguard the welfare of all residents, and staff have completed risk assessments for all residents because of this hazard. There is a washing machine in the utility room, and the home has a policy and procedure on the control of infection to ensure that the risk of cross infection is minimised. The use and storage of chemicals is satisfactory, and the home was clean and hygienic for the benefit of residents. 49 KING STREET CS0000044366.V182808.R01.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31 32 33 34 35 & 36 There is a stable and competent staff team in sufficient numbers who receive regular updated training to meet residents needs, but further attention needs to be focused on staff achieving the required National Vocational Qualification. EVIDENCE: All staff have job descriptions, verified with those staff on duty, and staff are aware of their respective roles in relation to other staff including team managers, and the acting care manager. There is a good team spirit and there was evidence of a good interaction between staff and residents and the home operates a key worker system. All staff have received a copy of the GSCC standards of conduct and practice, and there is a volunteers policy, but there are no volunteers employed at present. All staff receive statutory training, and the staff hours allocated amounts to 7 days training per year, per member of staff. The home is aware of the requirement for 50 of care staff to achieve NVQ Level 2 by 2005, and/or 80 of care staff working with service users aged 16 and 17 to have achieved NVQ Level 3 Caring for Children and Young People by 49 KING STREET CS0000044366.V182808.R01.doc Version 1.30 Page 23 2005, but this has not been achieved, nor likely to be achieved because of the shortage of assessors. All staff left in charge of young people aged 16 and 17 are at least 21 years of age. There were 4 residents accommodated, and there is a total staff complement of 27 (3 Support worker vacancies) including the care manager team managers and assistant team managers, to cover all three shifts in the home. The staffing levels found on this inspection were satisfactory. The ratio of care staff to service users is determined by the high dependency of service users, and was on a 1:1 basis at this inspection, during the waking day. The care manager is usually supernumerary, but covers for the team leaders and assistant team leaders when required. At the present time staff work a days and afternoon shift pattern, and there are permanent night staff who are deployed on a 1:2 basis ie if the home is full with 6 service users accommodated, the staffing complement will be 3 night staff on duty. Staff training is the responsibility of the care manager in conjunction with a team manager who is responsible for induction training. It is the care managers job to ensure that all staff receive the necessary training to meet residents needs, and the training co-ordinator from Hesley Village and College also has some input now that the home is part of HV&C. All staff receive induction and foundation training, and also equal opportunities and epilepsy training. A “continuous training progress development” file is maintained for each member of staff, and ongoing and future training needs are identified via supervision and appraisal sessions that are up to date and well organised. The homes induction programme from January 2004 has been linked to the Learning Disability Award Framework - LDAF - accredited training as required by this standard. The care manager and three team manager’s, have all achieved the D32/33 assessors award, and two other assistant team managers are working towards this qualification. The file of one new member of staff employed since the last inspection was checked and found to be satisfactory demonstrating a thorough approach to the recruitment and selection procedures. 49 KING STREET CS0000044366.V182808.R01.doc Version 1.30 Page 24 Regular staff meetings take place between the acting care manager and team leaders, and separate meetings between team leaders and care staff, as part of the homes thorough approach to resident care. 49 KING STREET CS0000044366.V182808.R01.doc Version 1.30 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37 38 39 40 41 42 & 43 Residents benefit from a home run well and in their best interests, but certain aspects of their health and safety need to be promoted further to safeguard their overall welfare. EVIDENCE: The care manager has considerable experience of working in a senior position in another organisation, caring for this client group, and is using this experience to good effect in her present role. She is a qualified nurse, and has submitted her registered managers award for verification. 49 KING STREET CS0000044366.V182808.R01.doc Version 1.30 Page 26 The care manager has delegated budgetary responsibility for the majority of expenditure headings incurred by the home in accordance with her position as the homes registered manager. Staff spoken to were comfortable with the care managers style of leadership and approach to management, and said that they felt that their views were received well and considered objectively. There is a recognised quality assurance system, ISO 9002, and in addition the staff carry out an internal audit on all aspects of its care procedures on a continual basis, and verifies these audits on documentation designed for this purpose. An independendent persons visit monthly as the Reg 26 (4c) visitor and prepares a report on the conduct of the home. The Groups own quality system, has now changed to the Hesley Infonet which is a computer system that provides access to policies and procedures and documentation on line. Further developments have been finalised to incorporate a Hesley Group wide e-mail system with the possibility of extending this for all residents. Currently, the views of residents are sought directly and via parents and social workers, and the care manager develops and holds an annual development plan for the home that contributes to the overall Hesley Village and College annual development plan. She also ensures that residents continue to develop via lifelong learning opportunities, and this is considered in periodic reviews with placing authorities and parents. There is a self-advocacy action pack from DFES, written in an appropriate format for residents should they want and be able to use it with staff assistance. As well as having a quality control audit, the home also has access to a specific person within the Hesley Group who is responsible for the development and implementationof the homes policies and procedures, who ensures that they comply with the relevant legislation. At the present time there is still no policy on emergency and crises to cover the emergency situation and evacuation following the homes electrical failure shortly after registration in 2003, and more recently the temporary accommodation of residents from Broughton Hall in Lincolnshire. 49 KING STREET CS0000044366.V182808.R01.doc Version 1.30 Page 27 All staff receive training in all aspects of safe working practices, including moving and handling, fire safety, first aid, and food hygiene, and staff are aware of infection control procedures. The fire records were satisfactory, and the electrical wiring was checked prior to registration in June 2003, and PAT testing was carried out in January 2005. The gas certificate however was not avaialble to be checked, and must be held on site and be avaialble for inspection. Risk assessments must be carried out on all aspects of this standard to safeguard residents and staff, and the public liability insurance certificate was out of date and expired at the end of January 2005 and must be updated to protect all people including visitors to the home. The care manager receives her supervision and appraisal from the Head of Hesley Village and College Sue Ekins, who visits the home on a frequent basis. 49 KING STREET CS0000044366.V182808.R01.doc Version 1.30 Page 28 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 3 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 4 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 4 4 4 4 4 4 4 Standard No 11 12 13 14 15 16 17 4 3 3 4 3 3 3 Standard No 31 32 33 34 35 36 Score 3 2 3 3 3 4 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 49 KING STREET Score 3 4 3 3 Standard No 37 38 39 40 41 42 43 Score 3 4 3 3 2 2 2 CS0000044366.V182808.R01.doc Version 1.30 Page 29 s 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 YA1 Regulation 4 Requirement Timescale for action Immediate 2. YA41 23 3. YA 42 23 4. YA43 23 The registered person must ensure that the home has an up to date Statement of Purpose and Service User Guide . The registered person must Immediate ensure that the home has access to a policy and procedure on emergencies and crises . The registered person must Immediate ensure that safe working practices are observed in relation to the absence of a gas boiler servicingcertificate for the hom e The registered person must Immediate ensure that an up to date public liability insurance certificate is displaye 49 KING STREET CS0000044366.V182808.R01.doc Version 1.30 Page 30 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 YA 32 Good Practice Recommendations The registered person should ensure that 50 of care staff achieve a qualification at NVQ Level 2 by 2005, and 80 achieve NVQ Level 3 when working with service users aged 16 and 17 49 KING STREET CS0000044366.V182808.R01.doc Version 1.30 Page 31 Commission for Social Care Inspection First Floor Barclay Court Heavens Walk Doncaster DN4 5HZ 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 49 KING STREET CS0000044366.V182808.R01.doc Version 1.30 Page 32 - 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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