Inspection on 26/06/08 for 49 Regents Park

This inspection was carried out on 26th June 2008.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

49 Regents Park 31/07/07

49 Regents Park 27/09/06

Similar services:

2 Perhaver Park

The Vicarage

7 Hyde Road

St George`s

5 Seafield Road

Credence House

Radfords

Trevaylor Manor

Extracts from inspection reports are licensed from CQC, this page was updated on 27/09/2008.

CARE HOME ADULTS 18-65 49 Regents Park 49 Regents Park Heavitree Exeter Devon EX1 2NZ Lead Inspector Vivien Stephens Unannounced Inspection 26th 27th June 2008 17:00 49 Regents Park DS0000067537.V364023.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 49 Regents Park DS0000067537.V364023.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. 49 Regents Park DS0000067537.V364023.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 49 Regents Park Address 49 Regents Park Heavitree Exeter Devon EX1 2NZ 01392 423847 01392 201324 info@regentsparkltd.co.uk 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) Regents Park Limited Post vacant Care Home 3 Category(ies) of Learning disability (3), Physical disability (3), registration, with number Sensory impairment (3) of places 49 Regents Park DS0000067537.V364023.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following categories: Learning disability (Code LD) Physical disability (Code PD) Sensory impairment (Code SI) The maximum number of service users who can be accommodated is 3. 2. Date of last inspection 31st July 2007 Brief Description of the Service: 49 Regents Park is a small registered care home for young adults. It provides individual care for up to three young people with learning or physical disabilities. The home provides bright, cheerful and nicely decorated family style accommodation with three single bedrooms. There is also a noisy room with a CD player. There is a garden to the rear of the property. The owner of 49 Regents Park, also runs 47 and 51, and the three gardens are joined together. The inspection report is on display. The cost of the service according to the manager is from £1000 per week with no extra costs. 49 Regents Park DS0000067537.V364023.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. Several weeks before this inspection took place we asked the providers to complete an Annual Quality Assurance Assessment. The document was not completed or returned by the date requested and therefore the information we wanted was not available at the time of this inspection. The registered manager, Paul Rosam, resigned in April 2008. The home is currently managed by the owner Larraine Thorne This inspection was originally planned to take place on an unannounced basis on Tuesday 24th June 2008. However, on arrival we found no-one was home. The next day we once again found that no-one was home so we telephoned and found that everyone living at 47 and 49 Regents Park attends a day service on weekdays run by Regents Park Ltd called The Hub. This is situated a few streets away in the area of Exeter known as Heavitree. We agreed to visit the following day at 5pm. On the evening of 26th June 2008 we toured both homes, 47 and 49 Regents Park, and looked at records relating to both homes, including care plans, medications, staff rotas and staff recruitment. We talked to the owner, Larraine Thorne, owner of the service. We visited The Hub on Friday 27th June where we met all of the people who live at 47 and 49 Regents Park, as well as day care staff and other staff who work at the two homes. We looked at the activities people can choose from at the day centre. At the time of this inspection there were three people living at 49 Regents Park and two people living in 47 Regents Park. The people living in 47 and 49 Regents Park have very complex needs. Some have limited verbal communication skills. One person living at the home was helped to complete a survey form and we also received one survey form completed by a relative, and one from a care manager. These survey forms helped us to form the judgements we have reached in this report. What the service does well: No new people have moved into the home in the last year. One person may soon be moving from 49 to 47 Regents Park and this will leave a vacancy. There are good admission procedures in place. Anyone who is thinking of moving in will be assessed to make sure the home is suitable and can meet 49 Regents Park DS0000067537.V364023.R01.S.doc Version 5.2 Page 6 their needs. Time is taken to help the person get to know the home and find out what it is like there before any decision to move in is made. There is good written information about the home, and information is also presented in other formats for people who cannot read. The day centre known as The Hub provides a very good range of activities and learning experiences. It is situated in a large house in the centre of Heavitree, with many rooms each holding a wide range of equipment giving people lots of things they can choose to do. There is a gym, a cinema, arts and crafts rooms, games, a relaxation room, a kitchen, dining room and garden. The staff at the day centre are qualified and experienced. We heard how they have helped people to gain new skills by working alongside them and breaking tasks down into achievable stages. They have helped people to create some wonderful art and craftwork that people can feel very proud of. Some lovely examples of the things people have created are displayed around the day centre and in 47 and 49 Regents Park. Each person has an individual programme of the things they want to do each week. The programme has been drawn up using symbols as well as words. The programmes include a wide range of activities, relaxation, and outings. Care plans have been written in an easy to read and straightforward manner using words as though the person has written the plans themselves. This style of writing can help staff to understand the personality, likes and dislikes, and individual care needs of each person. The plans set out how the person wants to be supported by staff with personal and health care tasks. The staff have helped people to choose the menu by showing people pictures of the foods they enjoy. Recording systems are in place to show that people have a healthy and balanced diet. Medications are stored and administered safely, We were given assurance that if people have any concerns or complaints these will be listened to and dealt with appropriately. The staff we talked to knew each person well and explained how they would recognise if a person who has poor verbal skills appeared distressed or showed unusual behaviour. They knew what to do to make sure people are safeguarded from harm or abuse. 49 Regents Park is a modern, comfortable, well decorated and attractively furnished family type home. A great deal of care and thought has been taken to make the place feel homely. Each bedroom has been individually decorated and furnished to reflect the personality and interests of the person. The rooms are spacious and well thought out. We found all areas were clean, well maintained, and safe. There is a stable staff team who have been carefully recruited and who understand how people want to be supported. We saw evidence to show that staff have received a range of training and there is a plan in place to ensure 49 Regents Park DS0000067537.V364023.R01.S.doc Version 5.2 Page 7 that future training needs will be met. Larraine Thorne told us that they plan to increase the training in the next year. What has improved since the last inspection? What they could do better: The care plans for people living in 49 Regents Park are much shorter than those that were drawn up last year for the people living in 47 Regents Park. They give brief information about each person’s daily care needs, but could be expanded to give staff a greater insight into the health and personal care needs, particularly where people have complex needs. Larraine Thorne told us she hopes to draw up care plans for people in 49 Regents Park to the same standard as those for people in 47. While the care plans generally gave very good guidance to staff, there were just a few instances where the plans were written in a way that might guide the staff to treat people in a parental manner rather than and adult-to-adult manner. While the plans generally helped staff to understand, guide and support people, there were a few instances where instruction suggested staff should ‘control’ people – this may lead to frustration or conflict. 49 Regents Park DS0000067537.V364023.R01.S.doc Version 5.2 Page 8 The staff team in both 47 and 49 Regents Park are female, although there are men living in each home. We suggested that consideration should be given to providing a balanced ratio of male/female staff to ensure people have the option of personal care from a member of staff of the same sex if they prefer. The menus are the same each week. We suggested that people might prefer to receive a more extensive range of meals and this could be achieved by gradually introducing new foods and finding out if people would like more changes of menus from week to week. Most of the staff have received some training on the safe administration of medicines. We recommended that a check is carried out to see if the training met the standards laid down by the nationally recognised training agency known as Skills for Care. Where necessary, staff should receive a more indepth training on this subject. The homes are generally well managed but the lack of a registered managed has meant that some of the administrative tasks that would normally be carried out by a manager have not been completed in recent months. These include updating and improving care plans, putting together and implementing a training plan, and completing the Annual Quality Assurance Assessment required by the Commission. Larraine Thorne told us she is actively seeking to employ a new manager. 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. 49 Regents Park DS0000067537.V364023.R01.S.doc Version 5.2 Page 9 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 49 Regents Park DS0000067537.V364023.R01.S.doc Version 5.2 Page 10 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. Anyone who is thinking of moving in can be confident they will be carefully assessed and given opportunities to get to know the home before any decision to move in is made. Information about what people are expected to pay for is unclear and needs to be updated. EVIDENCE: Since the last inspection no new people have moved into the home. At the time of this inspection one person was planning to move to 47 Regents Park. This will leave a vacancy in 49 Regents Park. A copy of the homes’ statement of purpose was provided during this inspection. It was last updated in October 2007. The document gives good information about the home. The admission procedure is explained and shows that there is a careful process to carry out a ‘needs led’ assessment by the home’s manager before admission. People are given good information about the home in a variety of formats. They are also given plenty of opportunities to visit and get to know the home before any decision to move in is made. 49 Regents Park DS0000067537.V364023.R01.S.doc Version 5.2 Page 11 The home has not updated people’s contracts of residence for several years. We found there was some uncertainty about what the home will pay for and what people are expected to pay for themselves. Larraine Thorne agreed to talk to people, their families and advocates in order to agree this for the future, and she will provide a new contract or statement of terms and conditions to ensure this is clearly set out in a formal agreement. 49 Regents Park DS0000067537.V364023.R01.S.doc Version 5.2 Page 12 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, and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff are given sufficient information to help them understand how people want to be supported, and how to help them make decisions and choices about their daily lives. Some adjustments to the way the care plans are worded will ensure there is a consistent approach to assisting people, rather than controlling. EVIDENCE: We looked at two different styles of care plan documents used in 47 and 49 Regents Park. Detailed and comprehensive care plans were drawn up a year ago for the people living in 47 Regents Park. Much simpler documents are in place for the people living in 49 Regents Park. Both types of document are written in a straightforward and easy to read style. They are written as though they are in the words of the person the document is about. Due to the complex needs of the people living in these homes the people they concern may not have actually spoken these words, but the style of writing provides a 49 Regents Park DS0000067537.V364023.R01.S.doc Version 5.2 Page 13 very good tool to help staff understand the personality of the person and the reasons why they may act or react in a particular way. Larraine Thorne said that they aim to draw up new care plans for everyone in the more comprehensive style of care plans used in 47 Regents Park. The plans we looked at included the aims and goals that people may hope to achieve. While the plans generally gave good information to staff about how to support and assist people we found a few instructions that suggested at times staff may take a parental or possibly a controlling approach. There were references to behaviours and personality traits, and how the staff should react. We talked to Larraine Thorne about how the wording could be altered in order to guide staff on how to support people in an adult-to-adult manner. On the second day of this inspection we visited the day centre used by people living in the home. We looked at the daily records written by staff both at the day centre and at the home. We found some very good examples of how staff had understood how people had been feeling, for example, if someone had been feeling unhappy or if they didn’t want to join in a particular activity. It showed that the staff were sensitive and understood if the person wanted to have some time to themselves for a while, or if they would prefer to do something else. In this way the staff had allowed and enabled the person to make a decision about what they wanted to do. We could see from the records that this approach had lead to very good outcomes for everyone involved. In just a small minority of entries we found references to the person being ‘uncooperative’ suggesting a more parental approach that may cause the person to feel angry or misunderstood. The member of staff in charge of the day centre said there are good relationships between the staff team and she felt she could provide some guidance and support to other staff to help them adjust their approach to people when faced with a potentially difficult situation. We observed staff and Lorraine Thorne interacting with the people living in the two homes, and at the day centre. We found there was a cheerful, relaxed and friendly atmosphere. The staff we talked to showed insight into people’s needs and were concerned to ensure people received the right level of support. We heard about how people are able to choose their own clothes, hairstyles, food, and daily activities. One person talked about her interests in hairstyles, clothing and music and we saw how the home helps her to follow these interests. At the last inspection we found that the home sometimes restricted or restrained people if they felt the person may be at risk. We were assured that such practices are no longer followed and the home now follows a ‘no restraint’ policy. 49 Regents Park DS0000067537.V364023.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): 12, 13, 14, 15, 16 and 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People participate in a wide range of activities and learning experiences that help them lead fulfilling lives and gain new skills. People have been supported to choose the food and drinks they like and to have a healthy and balanced diet, although they might prefer to receive a more extensive menu. EVIDENCE: Each person has an individual weekly programme showing the activities they want to do. We were given a copy of a typical plan that has been drawn up using symbols as well as words. On weekdays everyone attends a day centre owned by Regents Park Ltd. The day centre is called ‘The Hub’ and is situated a few streets away in the Heavitree area of Exeter. The building is a large double-fronted terraced house with enclosed rear garden. 49 Regents Park DS0000067537.V364023.R01.S.doc Version 5.2 Page 15 At The Hub there is a large information board that is changed throughout the day to give information about the things people will be doing each day. There are large symbols that can be attached to the board with Velcro. Each room is furnished and equipped to provide a range of different activities. One room is equipped with a large screen to show films. This room can also be used for music, either listening to music or playing instruments. Another room is used for sewing and fabric crafts, another for arts and painting, another for making cards. There is a room that is used for relaxation and massage, and one room is equipped as a gym. The garden is used in warmer weather for various activities including gardening and pet care. There is a kitchen and dining room and people can use the kitchen for cooking sessions. There are cupboards full of equipment covering a very wide range of activities. Every room in the home is bright and attractive, displaying many of the things people have created. There is a wide range games and puzzles. Sessions are usually fairly short so that those people who may have difficulty in concentrating are able to cope with new learning experiences. The staff we talked to described how people are helped to gain new skills. Tasks are broken down into small achievable steps, and in this way people are helped to reach new goals. We saw wonderful handicrafts that people had made, and heard how the staff have worked alongside them to create things they can feel very proud of. Some of the handicrafts are given by people as gifts, some things are displayed in their home, and some things are sold at coffee mornings. In addition to activities in the day centre we also heard that people regularly go out to do shopping, or go to the park. They also are offered regular swimming sessions at a local pool. On the afternoon of our visit everyone was watching a film. Mid afternoon everyone had a drink and a snack. People were happy, relaxed and smiling. The people living at 47 and 49 Regents Park have complex needs and are unable to participate in paid employment at the moment. The gardens of 47, 49 and 51 Regents Park have been joined together and redesigned to provide a safe and pleasant area. There is a large hut in the garden that has been connected to water and electricity services. They plan to use the hut for a range of ‘messy’ arts and crafts activities that people can do in the evenings and weekends if they want to. During the evening of our visit everyone in 49 Regents Park went out for a walk. Later in the evening people had a bath and then watched television in the lounge before going to bed later in the evening. One person enjoyed looking at photograph albums. She also talked about reading books and magazines and listening to music. Another person was sat at the dining room table with a puzzle. 49 Regents Park DS0000067537.V364023.R01.S.doc Version 5.2 Page 16 We heard that people regularly go out to the pub, to shows, or for meals out. Each year everyone has at least one holiday, and we saw photographs of holidays people have enjoyed in the past. Some people attend church services or church events. The home’s Statement of Purpose says that people are encouraged to follow their cultural, spiritual and religious beliefs. A member of staff will escort them to their chosen place of worship if required. The owner, Lorraine Thorne described the menus. The people living at 47 and 49 Regents Park have been helped to draw up a menu using pictures of favourite foods. Each person has chosen 2 or 3 meals they like. The menu is the same each week. On Sundays people always have a roast meal. We talked to Larraine Thorne about the possibility of introducing greater variety of meals and expanding the menus to a two or three weekly rota. On weekdays they all take a packed lunch to the day care facility. These contain a variety of foods including fresh fruit. We heard about dietary problems that have been experienced by people living in both 47 and 49 Regents Park and how the homes have sought specialist advice to help people deal with the problems. We heard how the staff try to encourage people to have a balanced and healthy diet. To achieve this they have at times had to restrict access to food and drink to prevent some people from making themselves ill. Records seen in the home and discussion with the home owner, Lorraine Thorne, showed that people have plenty of food and drinks at regular intervals throughout the day. 49 Regents Park DS0000067537.V364023.R01.S.doc Version 5.2 Page 17 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. People are well supported by staff to meet their personal and health care needs, although they cannot always choose to be helped by someone of the same sex. Medications are stored safely and well recorded, but staff would benefit from more in-depth training. EVIDENCE: The care plans we looked at gave good information about people’s preferred daily routines and how they wanted to be helped by staff. We heard about how people have been guided and supported to help them be as independent as possible when getting dressed/undressed and when washing or bathing. We also heard how the staff have helped people to overcome some distressing behaviours that affected their health and well-being and they are now much happier as a result. This was confirmed by one person we met. The home has mainly female staff working in the evenings and overnight. A male care support worker is employed 2 nights per week. This means that on 49 Regents Park DS0000067537.V364023.R01.S.doc Version 5.2 Page 18 the other 5 nights male residents do not have the option of being helped with personal care tasks by a member of the same sex. We talked to Larraine Thorn about the possibility of employing male staff in order to provide a balance of male/female staff. The home has consulted closely with health and social care professionals to ensure that each person receives the health care and support they need. Some people suffer from such health problems as epilepsy and these people have been closely monitored to ensure the treatment they receive is correct. A care manager gave their view about the care provided “Provides personcentred care to a complex and damaged individual in a homely environment. The owners have shown great commitment to this person.” One parent who completed a questionnaire told us “As far as I can see Regents Park responds … in an appropriate way, given (their) disability. They have systems ready as X does occasionally ‘flip’. I am a forthright person and have always been pleased that any questions that I’ve asked have been answered honestly and always with X’s best interests at heart.” Medications are stored securely in a locked cupboard. We found that people have very few prescribed medicines. These have been supplied in bottles or packets rather than the monthly blister packs used in some care homes. At the end of each month any unused tablets or medicines are returned to the pharmacy and new medicines are supplied – therefore there were no ‘brought forward’ amounts to be accounted for. Administration records were found to be well maintained, and no unexplained gaps were found. The home did not hold stocks of medicines that required refrigeration or controlled drugs and therefore no additional secure storage was required at the time of this inspection. We were told that staff have received some training on the safe administration of medicines, although it was not possible to check this from the staff records. We talked to Larraine Thorne about how to check to see if the training staff have received meets with the standards laid down by a nationally recognised training organisation known as Skills for Care. This should include a system of checking to ensure the member of staff is competent and has understood the training. 49 Regents Park DS0000067537.V364023.R01.S.doc Version 5.2 Page 19 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People can be confident that any concerns or complaints will be listened to and dealt with appropriately, and they will be safeguarded from harm or abuse. EVIDENCE: Larraine Thorne told us that everyone living at the home has received a copy of the complaints procedure. This has been written using symbols and has been explained to people. One person living at the home was helped by a carer to complete a survey form. They told us they knew how to make a complaint and who to talk to if they were unhappy. Larraine Thorne told us that all of the staff have received training on the protection of vulnerable adults. This was confirmed by the staff we talked to. Staff told us they felt completely confident in the way the homes handle concerns or grumbles and felt that any potential issues would be picked up and dealt with promptly. Staff said they would not hesitate to speak out if they had any concerns. The staff we talked to described how they would recognise if a person was unhappy, particularly those people who have poor verbal communication skills. No complaints have been received by the Commission or by the providers since the last inspection. Since the last inspection the home has been able to demonstrate they understand the local reporting procedures if a person may be at risk of harm or abuse. 49 Regents Park DS0000067537.V364023.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 and 30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People live in a modern, comfortable, well decorated and homely environment that provides a family atmosphere. All areas are clean and safe. EVIDENCE: During this inspection we looked at each room in 47 and 49 Regents Park, and also every room at the day centre (known as The Hub). All areas of each property have been attractively decorated and comfortably furnished to a high standard. The properties have been well maintained and were in very good order. All areas have been decorated in a modern style that is both practical, homely and stylish. There is a large lounge, separate dining room, and also a room in the basement known as the ‘noisy room’ where people can go to play music or other activities that may disturb others. 49 Regents Park DS0000067537.V364023.R01.S.doc Version 5.2 Page 21 Each person has a single bedroom that is large enough to be used as a bed sitting room. Bedrooms have been individually decorated and furnished to reflect the personality and interests of the person whose room it is. Throughout the home there were photographs, ornaments, and people’s artwork displayed, making it feel like a family home. Photographs of holidays and special occasions have been attractively framed and displayed. The gardens of 47, 49 and 51 have been joined together to create a large space for relaxing and socialising. There are level lawns and paths, and a large hut with verandah and sitting areas. 51 Regents Park is registered as a children’s home – it was recommended at the last inspection that the statement of purpose should be amended to show that people will be expected to share the facilities with young people under the age of 18 years. Since the last inspection a new heating system has been ordered for one of the houses. All areas of the home were found to be clean, fresh, bright and safe. 49 Regents Park DS0000067537.V364023.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 and 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People can feel confident that there is a stable and competent staff team who have been carefully recruited and who understand how people want to be supported. EVIDENCE: During this inspection we found that there are always at least 2 staff on duty, and at times 3 staff in each house. We looked at the current staff rota that confirmed these levels. At the day centre there were four staff on the day of this inspection working with 6 people. These staffing levels were sufficient to meet the needs of each person. This was confirmed by the staff we talked to, and by the people who completed survey forms. At the last inspection we found that poor recruitment practices had been followed. At this inspection we looked at the records of two new staff recruited since the last inspection. We found that an application form had been completed, at least two satisfactory references had been obtained and a criminal records bureau and protection of vulnerable adults check satisfactorily completed before the person started working directly with people living in the 49 Regents Park DS0000067537.V364023.R01.S.doc Version 5.2 Page 23 homes. This means that the home is now following good procedures to ensure people are in safe hands. We looked at the induction training records for new staff. These covered a wide range of areas and had been carried out over the first 4 weeks of employment. However, it was not certain if these meet the standards set out by the nationally recognised training agency known as Skills for Care. We suggested that Larraine Thorn checks this out. We were given a table showing all of the training staff have undertaken. We were told that in the last year many staff have received training on fire protection, protection of vulnerable adults, basic food hygiene, basic communication, Picture Exchange Communication, person centred planning, and some medication administration training. We heard that the providers want to improve the level of training in the coming year. They have up a plan to address any gaps in the training staff have received. 4 staff have already gained a nationally recognised qualification known as NVQ to at least level 2. Five more staff are in the process of obtaining this qualification. The member of staff who is in charge of the day centre has an arts degree and also a teacher training qualification. The staff we talked to said that the felt the level of training provided by the home is very good. We heard that each member of staff receives one-to-one supervision at least every 2 months, and sometimes more often. 49 Regents Park DS0000067537.V364023.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, 39, 41and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People can feel confident that the home is generally well managed, although some aspects of the management administration tasks could be improved. EVIDENCE: A new manager was appointed at the end of 2007 but he resigned in April 2008. At the time of this inspection there was no registered manager in post. The home was being managed by the provider, Larraine Thorne. She holds a nursing qualification known as RMNH, also the Registered Managers’ Award and is an NVQ assessor. She has managed care services since 1986. Several weeks before this inspection took place we asked the home to complete an Annual Quality Assurance Assessment and return it to the Commission by 5th June 2008. At the time of this inspection the form had not been completed. This indicated that the there may be some aspects of day-to49 Regents Park DS0000067537.V364023.R01.S.doc Version 5.2 Page 25 day management tasks that are not being carried out due to the absence of a registered manager. Larraine Thorne promised to complete and return the AQAA within the next few days. She also told us she is actively seeking to recruit a new manager. An administrator is employed to provide administrative support to the three homes. This person is based at The Hub. The staff we met were enthusiastic about their work and told us there is a happy team spirit. We were told that there are good communication methods within the home and an open approach to working with other professionals, and with the families of people who live there. We were told that they are planning to use advocacy services for people to ensure they have someone independent who can speak out on their behalf. One relative who responded to this inspection by completing a questionnaire told us they were happy with the way the home communicates with them and keeps them involved. Larraine Thorne said they have carried out their own survey of people’s views. We looked at the way the home handles people’s money. We saw bank statements for each person. Their personal allowances are paid into these accounts. They recently started to transfer £20 per week in cash to individual wallets to use for day-to-day expenses, but this has recently stopped. We saw the wallets and a recording sheet listing each item purchased and the current balance. These records appeared to be well maintained and periodically double checked to ensure they were correct. The home has not always ensured that people pay for their own personal requirements such as clothing or toiletries. We recommended that the home sets out clearly the items the home will pay for and the items people will be expected to pay for in the contract of residence. The home is treated as a small family home by the Fire Authority and therefore does not have to meet the same high standards of fire precautions as a larger home. However the providers have chosen to install fire alarm systems and records seen during this inspection showed these have been checked and maintained regularly. In addition staff have received regular fire drills and training. 49 Regents Park DS0000067537.V364023.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 2 2 3 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 4 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 3 2 x 3 x LIFESTYLES Standard No Score 11 4 12 4 13 4 14 4 15 4 16 4 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 3 2 x 3 x 2 x 2 3 x 49 Regents Park DS0000067537.V364023.R01.S.doc Version 5.2 Page 27 Are there any outstanding requirements from the last inspection? No 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 YA41 Regulation 24(2) Requirement The Annual Quality Assurance Assessment must be returned to the Commission within the required timescales. Timescale for action 14/07/08 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 YA5 Good Practice Recommendations The home should provide each person with an up-to-date contract or statement of terms and conditions that explains what the home will provide and what people will be expected to pay for. The home should enlarge the care plans to give the same level of detail as the care plans used in 47 Regents Park. The care plans should guide care staff to support people rather than to control them, and should help staff to understand why people may react in certain ways, and how to help them move on, for example, by suggesting something else they might prefer to do. People should be offered a greater variety of meals with the aim of expanding the menus. The possibility of employing male care staff should be considered in order to provide a ratio of male/female staff DS0000067537.V364023.R01.S.doc Version 5.2 Page 28 2 YA7 3 4 YA17 YA18 49 Regents Park 5 YA20 6 YA39 to provide support with personal care by a person of the same sex. All staff should receive or complete training on the safe administration of medicines to meet nationally recognised standards. All staff should be assessed regularly to ensure they are competent to administer medication. The home’s quality assurance systems should be formalised to ensure necessary checks that form part of it are completed within time scales. A development plan should be produced to include information from the surveys and future plans on how the home intends to continue improving. 49 Regents Park DS0000067537.V364023.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection South West 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 49 Regents Park DS0000067537.V364023.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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