Inspection on 28/12/06 for 52 Porthcawl Green

This inspection was carried out on 28th December 2006.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

52 Porthcawl Green 25/03/09

52 Porthcawl Green 08/01/09

52 Porthcawl Green 22/10/08

52 Porthcawl Green 31/10/07

52 Porthcawl Green 04/05/06

52 Porthcawl Green 15/11/05

52 Porthcawl Green 05/07/05

52 Porthcawl Green 13/07/04

Similar services:

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

Pinta

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

CARE HOME ADULTS 18-65 Porthcawl Green (52) 52 Porthcawl Green Tattenhoe Milton Keynes Buckinghamshire MK4 3AL Lead Inspector Mike Murphy Unannounced Inspection 28 December 2006 10:00 Porthcawl Green (52) DS0000030990.V316899.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 Porthcawl Green (52) DS0000030990.V316899.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. Porthcawl Green (52) DS0000030990.V316899.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Porthcawl Green (52) Address 52 Porthcawl Green Tattenhoe Milton Keynes Buckinghamshire MK4 3AL 01908 506865 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) The Disabilities Trust vacant Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Porthcawl Green (52) DS0000030990.V316899.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 4th May 2006 Brief Description of the Service: Porthcawl Green is a home in the community managed by the Disability Trust. The home accommodates three males with Autistic Spectrum Disorders. The house is situated on an estate in Milton Keynes, close to the Westcroft centre where there are several shops and supermarkets. Local transport networks gives access to central Milton Keynes and Bletcheley. There is a main line train station in the city giving access to London, the Midlands and the North. The home has three bedrooms, one en-suite, a sleeping in room, a visitor’s room and a bathroom on the first floor. On the ground floor there is a large lounge, dining room, office, laundry and kitchen. There is a small garden, mainly laid to lawn with pretty floral boarders. There is ample communal parking at the front of the home for staff cars and visitors. At the time of the inspection fees were £1431 - £1654.81 per week. Porthcawl Green (52) DS0000030990.V316899.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out by one inspector between the Christmas and New Year holidays in December 2006. The inspection methodology included discussions with the person in charge and other staff, examination of records (including service users files) and other documents, consideration of information submitted in advance of the inspection by a senior manager, consideration of questionnaires completed by all three service users and by a healthcare professional, and a walk around the house and garden. Two of three service users were on leave with their families and the one remaining service user seemed comfortable pursuing his own interests that day. The inspector and service user were introduced to each other at the start of the day. The home is a detached house in a quiet close in a residential area about four miles from central Milton Keynes. The area is accessible by car and bus. The home provides a comfortable environment for its three service users. Systems for assessing and recording service user needs are satisfactory. Each service user has a support plan in which his needs and a plan to meet those needs are recorded. The support plan is supplemented by other documents including an activities planner in which the service user records his plans for the week ahead. Service users are supported by staff in pursuing a range of activities, both in the home and in the wider community. Meals are planned with service users. On the basis of examination of menus submitted for this inspection it is felt that the current diet ought to be reviewed, ideally with the involvement of a dietician, taking account of current guidelines on healthy eating. Through a questionnaire, service users generally expressed satisfaction with the home and indicated that it is achieving its aim of enabling service users to lead relatively independent lives. All reported being well treated by staff but mixed views were expressed in relation to staff listening and acting on what service users say. Arrangements for staff training and development appear satisfactory and procedures are in place to provide regular supervision and annual appraisals. Staff files were not accessible because of the absence of a manager, therefore this inspection is unable to comment on the staff recruitment arrangements in this service. The post of manager was being advertised and it is to be hoped that an appointment will be made soon to this key post. Overall however, the inspection finds that this home is providing a valued service to its current service users, their families and other stakeholders. Porthcawl Green (52) DS0000030990.V316899.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: Managers should establish a system for periodically reviewing the quality of the service taking account of the views of a range of stakeholders. This should ensure that service users benefit from changes and developments in a service which is responsive to the views of its stakeholders. The home should achieve greater consistency in the formulation, application and review of risk assessments. Service users will benefit from thorough and consistent risk assessments and better management of risk. Porthcawl Green (52) DS0000030990.V316899.R01.S.doc Version 5.2 Page 7 The application of the complaints procedure should be reviewed to ensure that staff are aware of the outcome of all complaints. Service users will benefit from a service which takes account of the feedback received through complaints The current diet should be reviewed, ideally obtaining specialist advice from a dietician, with a view towards incorporating healthy eating guidelines into routine practice. Service users should gain health benefits from an improved diet. 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. Porthcawl Green (52) DS0000030990.V316899.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 Porthcawl Green (52) DS0000030990.V316899.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 and 5 Quality in this outcome area is good. Prospective service users are given information to help them make an informed choice about the service. The organisation has an assessment policy and procedures to ensure that prospective service users needs are assessed, that the home can meet those needs, and that any new service user is made to feel at home with current users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a Statement of Purpose and Service Users Guide to ensure that prospective service users are provided with a clear picture of the home, its primary aims, and the facilities it offers. A copy of each document is retained on service users files. The most recent admission was almost fours years ago so the home has not been in a position to consider new referrals. The Disabilities Trust has a policy governing assessment and admission processes which is implemented in line with the particular aims of each service. This home was considered to meet this standard at its last inspection in May 2006 and there have been no changes since then. Porthcawl Green (52) DS0000030990.V316899.R01.S.doc Version 5.2 Page 10 The home endeavours to meet service users needs through staff selection, its staff training and development processes, care planning, and liaison with other services in the community as required. A signed copy of the contract is retained on each service users file. Porthcawl Green (52) DS0000030990.V316899.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 and 9 Quality in this outcome area is adequate. Service user plans have been reviewed since the last inspection and on this inspection a comprehensive plan was in place for each service user. Care plans include evidence of liaison with health and social care agencies in the community. Risk assessments were on file but some variation in their completion could potentially impair their effective application. Indirect evidence indicates that service users are encouraged to participate in care planning and other activities in the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A service user plan is in place for each service user. Relevant documents comprise a ‘working’ file, a ‘medical/clinical’ file, a ‘day care’ file, an ‘archive’ file (for storing information not in current use), an ‘activity sheet’ and ‘daily notes’. The working file is the main document for each service user. Guidance notes located at the front of the working file state that the contents are to be reviewed every six months or after a major incident. A summary of the service user ‘This is me’ includes a photograph and is reviewed and updated annually. Porthcawl Green (52) DS0000030990.V316899.R01.S.doc Version 5.2 Page 12 Two of three files were examined. Files included assessments of needs, notes of the service user’s likes and dislikes, assessment of a range of activities of daily living (including eating, mobility, dressing, safety and security, learning, playing, response to environment, mental health (relapse prevention)), and goals and aspirations. Other sections headings included ‘Care Plan’, ‘Development Plan’ and ‘Individual Development Plan’. The ‘Development Plan’ included short term goals (such as practical skills). The format for risk assessments was straightforward and was reported to have been reviewed with service users in September 2006. Risk assessments are reviewed every six months or more often if necessary. The quality of risk assessments varied. Some were quite clear, outlining the activity (such as forgetting to take medication), the risk and the support required. Others were considered to be too broad in scope (such as ‘using the kitchen’) and needed more detail. Others seemed incomplete (such as ‘dealing with first aid’). Service users were reported to be involved in writing up and agreeing risk assessments but did not always sign them. The files examined included guidelines for dealing with problems which may occasionally arise (such as dealing with aggression and self-harm) as well the level of day to day support required by individual service users. A section headed ‘Cultural Needs’ included information on how the service user wished to spend special occasions. The daily file included a copy of the ‘weekly activity planner’ and ‘menu planner’. A copy of the weekly activity planner was also on the office notice board. This lists the activities planned by each service user for the week ahead. The ‘Clinical Medical File’ consisted of information related to healthcare including, medical or multidisciplinary reviews (including a mental health CPA (Care Programme Approach) review), information on medication, the service user’s weight, correspondence with health professionals, and information such as appointments with opticians. Entries in the daily notes sections of files were made on five occasions over each 24 hour period. A psychologist employed by The Disabilities Trust is available to provide specialist support and advice where required. Each service user has a key worker and co-worker in the home and a care manager (social worker) in the community. Care is reviewed six monthly through a process which involves the service user, parents and the professionals involved in his care. Service users are encouraged to participate in the care planning and decision making processes within the home. Monthly meetings are held between staff Porthcawl Green (52) DS0000030990.V316899.R01.S.doc Version 5.2 Page 13 and service users in the home. The notes of meetings held between August and December 2006 were provided for this inspection. Risk assessment processes are in place. While the structure is thorough, some variation in practice was noted and may indicate a need for further staff training and supervision in this subject. Porthcawl Green (52) DS0000030990.V316899.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 adequate. Service users are supported in participating in a range of activities both in the home and in the wider community. This enables individuals to pursue their interests, lead relatively independent lives and maintain contact with the wider community. Meals are drawn up with the involvement of service users. However, overall, the current diet in the home may not be in the longer term interests of service users health and the opinion of a dietician would be helpful. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users are supported in exercising and developing practical life skills through their participation in everyday tasks in the home and in pursuing their own interests in the community. Interests and plans are recorded in support plans and in the weekly activities planners (a weekly diary) which is completed by each service user. In the last inspection in May 2006, inspectors noted that activity planners had become ‘…a more fixed planner, the same week in week out’. On this inspection staff reported that this had now changed and that the Porthcawl Green (52) DS0000030990.V316899.R01.S.doc Version 5.2 Page 15 home had reverted to its earlier practice of a flexible planner drawn up by the service user with staff involvement as required. The views of the service users could not be sought because two out of three were on leave and the third seemed happy pursuing his own interests around the home that day. One service user attends Milton Keynes College and attends classes in information technology, performing arts, numeracy, and literacy. Other service users pursue their interests in music. On the day of this inspection the one service user in the house pursued his own activities with occasional interactions with staff. The home is around ten minutes by car from Milton Keynes city centre. Buses also travel to the centre from a stop nearby. Service users go to the centre with or without support by staff as required. One service user is also said to go to Bedford or Oxford by bus on occasions. Other activities in the community include trips to the cinema, library, shopping, a pub, or occasional lunches out. The home receives the weekly local paper (‘The Milton Keynes Citizen’) and has a television, music centre and DVD and video for service users use. Two service users have a particular interest in music. All three service users are reported to maintain contact with their families and take their holidays with them. Service users daily routines are set out in their weekly planners. All service users have keys to their room doors. One has a key to the front door of the house, it is reported that the other two service users are happy not having a key. All are registered to vote. Menus are planned with service users. Breakfast consists of cereals, toast and beverages. Lunch is whatever the service user fancies – pies, burgers and grills seemed popular in the menus copied to this inspection. The evening meal, dinner, is the main meal of the day and again reflects the service users choices. In the two menus submitted for this inspection dinners included; lasagne and garlic bread, sausage casserole, fish and chips, roast beef, lamb chops and sautéed potatoes, chicken drumsticks, and, Chinese stir fry with fried rice. A bias towards meat (12 out of 14 dinners) and high carbohydrate dishes (e.g. fried rice, roast potatoes, potato wedges, pasta, garlic bread) is noted but staff said that that is what the service users prefer. While it might not be possible to make sudden changes to the diet, the longer term implications of a diet high in meat, carbohydrate and fat (as in sauté potatoes, fried rice, garlic bread, pastry, and breaded chicken for example) needs to be considered. The opinion of a dietician would be helpful. Porthcawl Green (52) DS0000030990.V316899.R01.S.doc Version 5.2 Page 16 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is good. Guidance and support is provided to service users when required. Arrangements for supporting service users in contacts with healthcare services and for the control and administration of medicines appear satisfactory. This ensures that service users receive appropriate support in meeting their healthcare needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users’ needs for personal support are recorded in their service user plans. Service users in this home may require occasional guidance but are generally independent as far personal care is concerned. All service users are registered with a GP. One service user was regularly seeing a psychologist. Correspondence was on file with a community psychiatric nurse (CPN) providing evidence of contact with specialist mental health services. Service users obtain optical and dentistry services as NHS patients. Medicines are prescribed by the service user’s GP and are dispensed by Boots Chemists. Wherever possible the home uses the Boots monitored dosage Porthcawl Green (52) DS0000030990.V316899.R01.S.doc Version 5.2 Page 17 system (MDS). Medicines are delivered by Boots but may also be collected from a local branch of Boots as required. The organisation has a policy governing the administration of medicines by staff. This was last reviewed in March 2006. Staff training is provided by Boots Chemists. ‘Homely remedies’ (such as analgesics) may not be administered without the authorisation of the GP. Medicines Administration Records (‘MAR charts’) examined appeared in order. Arrangements for the storage of medicines appeared satisfactory. The metal medicines storage cabinet had been affixed to the wall in the office in line with a requirement made at the last inspection in May 2006. Arrangements are in place for recording medicines returned to the pharmacy. The home did not appear to have a comprehensive reference text on medicines for staff and service user use. It was noted that a record of service users’ wishes in the event of their death had been made in each service user plan. Porthcawl Green (52) DS0000030990.V316899.R01.S.doc Version 5.2 Page 18 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is adequate. The home has a policy governing its response to complaints. However, its application in practice seems inconsistent and home staff do not appear to be fully involved in all aspects of the process. This may lead to some complaints being only partially addressed. The home has a robust framework of policy, procedure, reporting arrangements and staff training with regard to the protection of vulnerable adults (POVA). This aims to protect service users from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a complaints policy and records of complaints received are retained. Staff are required to sign that they understand the policy. However, it seemed as if some elements of the complaints process happened at higher management levels and that staff in the home were not always informed of the outcome. It was reported that some, but not all, expressions of dissatisfaction were recorded. Together, these potentially deny the service the opportunity to learn from the feedback which complaints provide. The policy on the protection of vulnerable adults (POVA) was revised in 2005. Staff training is provided and staff attended events in February and October 2006 and further training is available in January 2007. The home had a copy of the Milton Keynes Council (and other statutory services) policy on the protection of vulnerable adults. Staff interviewed were aware of the POVA issues and of the reporting arrangements within The Disabilities Trust. Porthcawl Green (52) DS0000030990.V316899.R01.S.doc Version 5.2 Page 19 No complaints or concerns have been reported to CSCI since the last inspection. Porthcawl Green (52) DS0000030990.V316899.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 good. The home is located in a quiet residential area served by public transport. The home is an ordinary domestic house which is well furnished and suits the needs of current service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home consists of a detached two storey house which located in a small quiet close, part of a larger development, just under four miles from Milton Keynes city centre. There are frequent, variable frequency, buses from a nearby stop to the centre and other areas. The home is not suitable for someone with significantly impaired mobility and does not permit wheelchair access. The accommodation on the ground floor is comprised of the entrance hall, shower and WC, living room, dining room, laundry/utility room, kitchen and office. First floor accommodation consists of a staff sleep-in room, a “chill out” (or quiet)room, bedrooms, bathroom and WC. One of the bedrooms has an enPorthcawl Green (52) DS0000030990.V316899.R01.S.doc Version 5.2 Page 21 suite shower and WC. There is a small garden with seating areas to the rear of the house. The home is comfortable and well furnished. Furnishings in the lounge include two sofas and an armchair, television, video, DVD, and bookcase. The dining room furnishings include a table and chairs, piano, desk and cabinet. Patio doors lead to the garden. The kitchen is quite well equipped with wall and floor mounted storage units, a freezer (which was due for defrosting although the temperature was satisfactory), an electric cooker, dishwasher, microwave, and a wall mounted boiler. The laundry/utility room includes a washing machine and dryer for staff and service user use. All areas of the home visited were in good order, tidy and clean. The home is well furnished and well decorated. Since the last inspection the entrance hall and stairs have been redecorated. The home suits the needs of current service user. Porthcawl Green (52) DS0000030990.V316899.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, 33, 35 and 36 Quality in this outcome area is adequate. Staffing levels appear satisfactory in this small home and the organisation provides training across a range of subjects. Systems of staff supervision and appraisal are in place. Together, these help to ensure that there are sufficient numbers of appropriately trained and supported staff to meet service user’ needs. Evidence of staff recruitment procedures was not accessible on this occasion. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The staff selection and training and development procedures of The Disabilities Trust aim to ensure that staff have the competencies and qualifications required to work effectively with service users. Of six staff employed in the home at the time of this inspection one had acquired the NVQ3 ‘Promoting Independence’, two were currently undertaking it, and three were registered to start sometime in 2007. Problems in maintaining continuity with NVQ assessors was reported to have led to delays in some staff completing NVQ training. Some staff had acquired Learning Disability Award Framework (LDAF) accredited training and were said to be keen to progress on to the NVQ3. Other staff had supplemented such formal work by informal training in mental health subjects with a psychologist. Porthcawl Green (52) DS0000030990.V316899.R01.S.doc Version 5.2 Page 23 The present staff establishment provides for two to three staff in the morning, two in the afternoon and one ‘sleep-in’ at night. A duty manager is always on call. The gender staff mix consisted of four females and two males. The staff group are of mixed ethnicity. It was reported that staff aim to have monthly staff meetings but have been unable to achieve this during 2006. According to the records staff meetings were held in April, September, November and December 2006. Staffing levels were reported to be satisfactory and there were no vacancies, other than at management level (see below) at the time of this inspection. The staffing of the home is supplemented by relief staff from another service nearby. No new staff have been recruited since the last inspection in May 2006. Staff files were not accessible because a manager was not on site. It needs to be noted that this is the second occasion in 2006 in which staff files were not examined. On the first occasion the files had been removed for copying. This matter may need to be followed up by CSCI on another occasion because this standard has not been fully assessed during the current inspection year. One support worker has a lead role in training. The training plan for the final quarter of the 2006 calendar year included food hygiene, fire safety, moving and sliding, emergency first aid, medication, POVA, epilepsy, CSIP (‘Strategies, Crisis Intervention and Prevention’), autism awareness, Aspergers syndrome, and health and safety. One of the staff on duty said that over the past year she had undertaken training in food hygiene, infection control, Makaton and “Mental Health” as well as the NVQ3. Training is carried out at another Disabilities Trust service (T.E.M House) in the Emerson Valley area of Milton Keynes. Training appears to well organised in the organisation. A staff supervision policy is in place. All staff receive supervision monthly by a senior manager. Meetings are planned and records kept. A copy of the meeting is retained on file and by the member of staff. Staff appraisals take place annually. It was reported that all staff in the home had been appraised in 2006. Porthcawl Green (52) DS0000030990.V316899.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 and 42 Quality in this outcome area is adequate. The post of manager was vacant at the time of this inspection. While arrangements were in place to provide management cover from another service, the ongoing absence of a person in such a key position potentially compromises the quality and development of the service. This could disadvantage service users in time. Arrangements for maintaining safe working practices appear satisfactory. These aim to ensure that service users live in a safe environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The position of manager was vacant at the time of this inspection. The post had been advertised internally and externally. In the absence of a manager the home was receiving management support from another service nearby, Stolford House, and from the Unit General Manager (UGM). The arrangements Porthcawl Green (52) DS0000030990.V316899.R01.S.doc Version 5.2 Page 25 for maintaining management cover in such circumstances is a matter for an organisation, but the absence of a designated lead person, with appropriate delegated authority, may compromise the quality of the service if the position is not rectified in the near future. However, there was no evidence of any adverse effects upon service users or staff at the time of this inspection. The home did not have an annual development plan. The quality of the service is assessed through a number of perspectives. The home does not conduct a stakeholder survey or carry out periodic systematic quality assurance exercises. The UGM conducts regular Regulation 26 visits and files a report on these. Staff supervision and appraisal processes offer opportunities both to assess and to influence the quality of some elements of the service. Individual service user support and development plans, in particular the identification and achievement of short and long term goals, are key indicators of quality as far as outcomes for service user are concerned. Multi-agency reviews provide opportunities to assess the quality of the service. Inspection is also seen as a time to review and assess the quality of the service. The experiences of service users as reported through a CSCI survey were mixed. A majority reported that they ‘always’ make decisions about what they do each day. All reported that they can do what they want to do at all times. The majority knew to whom they should make a complaint. All found the home ‘fresh and clean’. The majority reported that the staff treat them well. Different views were expressed in relation to care staff listening and acting on what they said - one reported ‘never’, one reported ‘always’ – one additional comment on this point said ‘It sometimes seems they don’t listen to reason’. The one professional respondent who returned a survey form expressed satisfaction with the overall care provided. The home’s arrangements for maintaining a safe environment appear satisfactory. The organisation has a health and safety committee and a health & safety policy. It was reported that risk assessments are reviewed monthly. Staff receive basic and update training in Moving & Handling, Fire Safety, COSHH, First Aid, Food Hygiene and Infection Control through a variety of means including, training at T.E.M. House in Milton Keynes, St. John’s Ambulance in Bedford (for first aid) and private training providers (for food hygiene and moving & handling). COSHH information is available to staff and service user and COSHH materials are stored in a locked cupboard in the laundry room. The home reports that it was visited by the fire authority in October 2006 but no correspondence following that visit was on file. A fire risk assessment was carried out in October 2006. The most recent fire drill was in August 2006. Fire safety equipment was checked in June 2006. The home’s emergency lighting is checked monthly. Fire alarm points are checked weekly. Gas was checked in May 2006. The home’s fixed electrical wiring was checked in July 2002. Portable electrical appliances were tested in October 2006. There was no Porthcawl Green (52) DS0000030990.V316899.R01.S.doc Version 5.2 Page 26 record of a check for Legionella having being carried out in 2006. It is noted that the home does have guidelines for cleaning and disinfecting shower heads weekly. Procedures are in place for recording accidents. Porthcawl Green (52) DS0000030990.V316899.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 3 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 3 34 X 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 2 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 1 X 2 X X 3 X Porthcawl Green (52) DS0000030990.V316899.R01.S.doc Version 5.2 Page 28 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA39 Regulation 24 Requirement It is required that the registered person establish a system for reviewing (at appropriate intervals) and improving the quality of the service. Timescale for action 30/06/07 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 YA9 YA17 Good Practice Recommendations It is recommended that managers achieve greater consistency in the formulation, application and review of risk assessments. It is recommended that managers review the current diet in this service, ideally obtaining specialist advice, with a view towards incorporating healthy eating guidelines into routine practice. It is recommended that managers review the application of the complaints procedure to ensure that all aspects of a complaint are dealt with and that staff are aware of the outcome of all complaints It is recommended that managers ensure that regular staff meetings take place – at a minimum six per year. DS0000030990.V316899.R01.S.doc Version 5.2 Page 29 3 YA22 4 YA33 Porthcawl Green (52) Commission for Social Care Inspection Oxford Office Burgner House 4630 Kingsgate Oxford Business Park South Cowley, Oxford OX4 2SU 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 Porthcawl Green (52) DS0000030990.V316899.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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!