Inspection on 31/10/07 for 52 Porthcawl Green

This inspection was carried out on 31st October 2007.

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 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

52 Porthcawl Green 25/03/09

52 Porthcawl Green 08/01/09

52 Porthcawl Green 22/10/08

52 Porthcawl Green 28/12/06

52 Porthcawl Green 04/05/06

52 Porthcawl Green 15/11/05

52 Porthcawl Green 05/07/05

52 Porthcawl Green 13/07/04

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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 31 October & 13 November 2007 11:00 st Porthcawl Green (52) DS0000030990.V346775.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.V346775.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.V346775.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 507149 01908 508900 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 post Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Porthcawl Green (52) DS0000030990.V346775.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28th December 2006 Brief Description of the Service: Porthcawl Green is a home in the community managed by the Disability Trust. It provides accommodation and support for three service users with Autistic Spectrum Disorders. The house is situated in a quiet residential area of Milton Keynes, close to the Westcroft centre where there are several shops and supermarkets. Local bus networks provide regular access to central Milton Keynes and Bletchley. There are main line rail stations in Milton Keynes and Bletchley giving access to London, the Midlands and the North. The home has three bedrooms, one en-suite, a staff sleep-in room, office and a bathroom on the first floor. On the ground floor there is a large lounge, dining room, ‘chill out room’, laundry and kitchen. There is a small garden, mainly laid to lawn with floral boarders. There is ample communal parking at the front of the home. At the time of the inspection fees were £1251.73 to £1707.76 per week. Porthcawl Green (52) DS0000030990.V346775.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, on one day in October and one day in November 2007. The inspection included discussion with the manager, staff and a service user, two visits to the home, consideration of information provided by the manager in advance of the inspection, consideration of survey forms returned in connection with the inspection, examination of records (including care plans and staff records) and a tour of the home and garden. The home is a service provided by the Disabilities Trust for people with autistic spectrum disorder. It is located in a quiet residential area of Milton Keynes. The area is served by buses to Milton Keynes, Bletchley and other areas. The home has not admitted a new service user since the last inspection. The Disabilities Trust has procedures in place for assessing the needs of prospective service users. The home aims to ensure that people’s diverse needs are met. The home has comprehensive care plans in place for each service user. Care plans are detailed and include aspects of care provided in the home and in the wider community. Care plans included evidence of liaison with other health and social care services and of the involvement of the service user. Service users are supported by staff as required. However, there were indications in some responses to the CSCI survey that the nature and extent of this support may not be sufficient in all circumstances and this would merit exploration by the manager. Service users make use of services in the community and it is the intention of the new manager to increase the range of these with the aim of enabling service users gain greater independence. The process will include a check that organisations providing services in the community take account of the rights of people with a disability to access such services. It is reported that, in some respects, there are gaps in services for people with autistic spectrum disorder in the area. Weaknesses are noted in providing evidence of conformance to the Regulations in staff recruitment. Staff appear well supported and the organisation has good arrangements in place for staff training and development. Since the last inspection a manager has been appointed. This is a welcome development. The manager had been in post for four months at the time of this inspection, and, apart from settling in to the post, was establishing priorities for management attention. Three areas identified to date were: establishing a higher level of consistency in the provision of services, improving administrative systems, and promoting greater independence for service users. A programme of quality assurance would support this work and Porthcawl Green (52) DS0000030990.V346775.R01.S.doc Version 5.2 Page 6 would ensure that the views and interests of stakeholders, particularly service users and their families, are taken into account. What the service does well: What has improved since the last inspection? What they could do better: Ensure that evidence of conformance to good practice in all aspects of health and safety is readily accessible for inspection at all times. Amend, and where necessary supplement, the organisation’s policies on complaints and safeguarding vulnerable adults so that staff and service users have access to accurate local information. Establish procedures for periodically reviewing and improving the quality of the service taking account of the views of stakeholders. Porthcawl Green (52) DS0000030990.V346775.R01.S.doc Version 5.2 Page 7 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.V346775.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.V346775.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): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users are provided with information to help them make an informed choice about the service. The organisation has assessment policies and procedures to ensure that prospective service users needs are assessed, that the home is likely to be able meet those needs, and that any new service user is supported in settling in to home. EVIDENCE: The home has not had a new admission since the last inspection so it was not in a position to provide evidence on this standard. Referrals are dealt with through the organisation’s head office in Cambridge in liaison with the unit general manager, who is based in Reading, and the home manager. A copy of the statement of purpose and service user’s guide is made available to the prospective service user. In the case of a referral which is accepted arrangements are made for the prospective service user to visit the home and meet staff and current service users. Where the referral is progressed arrangements are made for a whole day visit and overnight stay. This allows staff to complete a pre-admission assessment of needs, decide if the home can meet those needs, and for the prospective Porthcawl Green (52) DS0000030990.V346775.R01.S.doc Version 5.2 Page 10 service user, staff and current service users to consider whether the home would be an appropriate place for the person. Arrangements are then made for a ‘trial’ admission. The home aims to meet service users needs through the organisation’s staff selection processes, its staff training and development programme, care planning, and liaison with other services in the community as required. Porthcawl Green (52) DS0000030990.V346775.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 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The care and support provided to service users addresses a range of needs and is well structured. Systems for care planning and risk assessment are being reviewed but those in place at the time of this inspection supported the range of care required by each service user. EVIDENCE: A comprehensive plan of care is in place for each service user. The structure of care plans is reported to be under review by the organisation and it is expected that new plans are likely to be based on a ‘person centred plan’ (PCP) approach. In theory, this aims to ensure that care planning is centred on the needs of the person and the structure is in a form which is more accessible to service users. The current structure of care plans is thorough and includes: personal information, pre-admission assessment, current needs, future needs, statement of purpose, service user guide, records of multi-agency reviews, Porthcawl Green (52) DS0000030990.V346775.R01.S.doc Version 5.2 Page 12 detailed notes on a range of activities (written five times a day), day care, risk assessments, correspondence, and miscellaneous information (such as information on activities, finance, or personal papers). Plans include evidence of the involvement of the service user and liaison with other health and social care agencies in the community. Care and support is provided in close consultation with the service users – a process that is essential in a service which aims to support its service users to move on to more independent accommodation in the future. Care plans are generally reviewed annually with care managers - more often if indicated – and are kept under review on an ongoing basis within the home. Risk assessments cover a number of activities and the process of risk assessment was being reviewed by psychologists around the time of this inspection. The care programme is negotiated with service users and recorded in detail in the care plan. This includes the person’s routine for day, the form and the level of support required when involved in activities, and checklists for participating or completing activities. Both staff and service users provide feedback to each other on day-to-day matters. Porthcawl Green (52) DS0000030990.V346775.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 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 provided with the involvement of service users. EVIDENCE: The programme of care and support aims to assist service users to improve self-confidence, self- esteem and social skills. This is achieved through day-today interactions within the home, group discussions, participation in programmes agreed through care planning, individual and group outings, and social events – such as meals out or visits to places of interest or entertainment. It was reported that on occasions there can be problems in finding appropriate services in Milton Keynes. Established services for people with a learning Porthcawl Green (52) DS0000030990.V346775.R01.S.doc Version 5.2 Page 14 disability or mental health problem are not always suitable for the particular needs of the service users in this home. The home is unable to directly influence such matters but it would be helpful if such information were communicated to local health and social services departments who commission services for people. At the time of this inspection one service user regularly attended Milton Keynes College. Other service users were supported as required in accessing social and recreational services in Milton Keynes – including obtaining concessionary rates where possible. All were able to pursue their own interests – music, drama and current affairs among others. All service users were in regular touch with their families and had time away from the home on occasions. One had recently returned from a week’s holiday with a member of staff in Blackpool. The daily routine is structured and service users are expected to plan a diary for the week. All are up early and after breakfast either go to college or do a planned activity of some kind for the morning and perhaps the afternoon. Service users participate in the house cleaning rota and, with staff support, look after their own rooms and laundry. House meetings are held monthly. One respondent to the CSCI survey carried out in connection with this inspection expressed concern for what that person felt was a decline in the quality and quantity of staff interaction with, and support to, service users. The respondent felt that staff expectations in terms of service user independence might, on occasions, be exceeding the ability of some service users to meet them. The respondent felt that support from staff sometimes fell short of that required. Other respondents felt that staff ‘sometimes’ listened and acted on what service users said (the choices were: ‘Always’, ‘Usually’, ‘Sometimes’ and ‘Never’). Meals are planned together although the new manager is interested in developing a more individual programme in support of achieving greater independence for each service user. Breakfast during the week usually consists of cereal, toast and hot drinks. Lunch is taken wherever the service user happens to be – if in the home then they help themselves to food from the kitchen. Dinner is taken as a communal meal in the evening. One service user was preparing and cooking his own meal on four days a week as part of a rehabilitation programme. Staff provide support to all service users as required. Porthcawl Green (52) DS0000030990.V346775.R01.S.doc Version 5.2 Page 15 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. This judgement has been made using available evidence including a visit to this service. Guidance and support is provided to service users as required. Arrangements for supporting service users in contact 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. EVIDENCE: The service users resident at the time of this inspection had established routines, which, in part, were negotiated with home staff and in part, reflected the organisation’s approach to supporting people with autistic spectrum disorders. Individual support programmes are based on the outcome of individual assessments. The level of support required is outlined in some detail in the person’s care plan. However, as mentioned in the previous section there may be a need for staff to consider whether the nature and extent of support is sufficient on all occasions. Porthcawl Green (52) DS0000030990.V346775.R01.S.doc Version 5.2 Page 16 All service users are registered with a local GP. Where required service users were also in touch with the local community learning disability team (CLDT) and community mental health team (CMHT). The multidisciplinary services of each team could also be accessed via the service users GP. Some service users had used the services of an optician in Westcroft (a nearby shopping area) and an NHS dentist practice in Netherfield (another area of Milton Keynes). The home’s practice in relation to the control and administration of medicines is governed by the policy of the Disabilities Trust. This was last reviewed in March 2006. Medicines are prescribed by the GP. The exception is Clozaril which is prescribed following a blood test. Medicines are dispensed by Boots Chemists and all staff receive training in the Boots monitored dosage system (MDS). No service user was managing their own medication at the time of this inspection visit. Arrangements for storage are generally satisfactory. Medicines are stored in a metal cabinet in the office. Another cabinet for the storage of controlled drugs (CD) was on order at the time of this inspection visit. On inspection it was noted that external preparations (such as creams) had not been labelled and dated when opened. The medicines administration records (‘MAR’ charts) examined were satisfactory. The home’s arrangements had not recently been audited by a pharmacist. Although it is a small home, an audit would be desirable. The home did not have a readily accessible copy of the guidelines of the Royal Pharmaceutical Society of Great Britain – a new edition was published in October 2007 (‘The Handling of Medicines in Social Care’). Porthcawl Green (52) DS0000030990.V346775.R01.S.doc Version 5.2 Page 17 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. This judgement has been made using available evidence including a visit to this service. The home has a policy for recording and investigating complaints. It has a framework of policy, reporting arrangements and staff training with regard to the protection of vulnerable adults (POVA). Together, these aim to protect service users from abuse and to ensure that complaints are properly investigated. However, both policies require the attention of managers to ensure that they take account of local arrangements. EVIDENCE: A copy of the organisation’s complaints policy dated June 2005 is given to each service user and is retained in a folder with other papers (including the service user guide, statement of purpose, and contract). It is noted that the document has not been amended for local use and that it is written in an impersonal style. While this is acceptable in a policy document it not particularly helpful to service users. It would be advisable to amend the document for local use (to include contact details of the local CSCI office) and to consider creating a more straightforward summary of the policy for service users. CSCI has not received any complaints about this service since the last inspection. The home has a copy of the organisation’s policy on the protection of vulnerable adults (POVA). This is a comprehensive policy with an excellent flow Porthcawl Green (52) DS0000030990.V346775.R01.S.doc Version 5.2 Page 18 chart to guide staff in the event of a POVA investigation. The home did not have a copy of the Milton Keynes multi-agency policy on this subject. Staff receive training on safeguarding vulnerable adults and on dealing with aggression (through ‘SCIP’ (strategies for crisis intervention and prevention) training). Porthcawl Green (52) DS0000030990.V346775.R01.S.doc Version 5.2 Page 19 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. This judgement has been made using available evidence including a visit to this service. 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. EVIDENCE: The home is a detached two storey house located in a small quiet close, part of a larger residential development, just under four miles from Milton Keynes city centre. There are frequent buses from a nearby stop to Milton Keynes, Bletchley and other areas. The home is not suitable for someone with impaired mobility because it does not facilitate wheelchair access. The accommodation on the ground floor comprises: the entrance hall, staff shower and WC, living room, dining room, laundry/utility room, kitchen and ‘chill out’ room. The ‘chill out’ room was being relocated from the first floor and was to be redecorated soon after this inspection. The first floor accommodation comprises: a staff sleep-in room, the office, bedrooms, bathroom and WC. One Porthcawl Green (52) DS0000030990.V346775.R01.S.doc Version 5.2 Page 20 of the bedrooms was reported to have an en-suite shower and WC. There is a small garden to the rear of the house. The garden has a small patio area with seating, an area of lawn, flower beds and a shed. 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, computers, sideboard and notice board. Patio doors lead to the garden. The kitchen is suitably equipped with wall and floor mounted storage units, a freezer (a new freezer had been purchased between visits, storage was likely to be relocated to the ‘chill out’ room), an electric cooker, dishwasher, microwave, and a wall mounted boiler. The laundry/utility room includes a washing machine, tumble dryer, sink and storage and is used both by 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 ‘chill out’ room has been relocated to the ground floor, the office moved to the first floor. The home suits the needs of current service users. Porthcawl Green (52) DS0000030990.V346775.R01.S.doc Version 5.2 Page 21 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, 34, 35 and 36 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staffing levels are considered satisfactory and staff have access to a range of training and development opportunities. This aims to ensure that there are sufficient numbers of appropriately trained and supervised staff to meet people needs. However, failure to evidence full conformance to the Regulations in staff recruitment may reflect weaknesses in administrative systems which could put service users at risk. EVIDENCE: Staffing at the time of this inspection consisted of four permanent staff and four bank staff. This maintained the following staff levels: two support workers in the morning, two support workers during the afternoon and evening, and one sleep-in support worker at night. These figures exclude the manager. The home has access to a staff bank system which maintains staffing levels during times of leave or when there is a vacancy. The home occasionally uses agency staff, although the number of occasions when such staff are used is reported to have declined since the last inspection. The manager said that staff and service users have met with staff from the Porthcawl Green (52) DS0000030990.V346775.R01.S.doc Version 5.2 Page 22 agency who might be likely to work in the home. This ensures that service users and staff will have some knowledge of each other, and that agency staff will know how the home works. Staff appointed since the last inspection have many years experience of working in social care and social housing services. Vacancies for positions in the home are advertised locally. Applications are dealt with at the organisation’s offices in Cambridge. Applicants are required to complete an application form and appointments are subject to satisfactory references, an enhanced CRB, and where required, relevant work permits. During the inspection visit two personnel files were examined in the presence of the manager to check conformance with Schedule 2 (of the Regulations). In both cases an application form had been completed and two references received. Neither had a recent photograph. In one case, and in accordance with the Schedule, an enhanced CRB had been received prior to the person taking up appointment. In one case neither a POVA First or enhanced CRB was on file. In one case health status had been self-declared on the application form. No information on the health status of the second person was on file. New staff are required to complete a comprehensive induction programme. This appears to conform to the Skills for Care common induction standards. A time period for completion is not specified but the manager thought it not unreasonable to expect it to be completed within six months. The organisation is reported to provide good training support to staff and has its own NVQ department based in Burgess Hill in West Sussex. It is accredited by ‘Investers in People’. Two staff had just started NVQ3 training around the time of this inspection. The manager will be starting an NVQ4 course within the next year. Other training attended by staff include food hygiene, first aid, safeguarding vulnerable adults (also known as ‘POVA’), ‘SCIP’ (Strategies for Crisis Intervention and Prevention) and medicines administration. Training planned for the first quarter of 2008 includes sexuality and relationships, mental health training and medication. The manager is following an in-house management development programme. Each member of staff has a folder which includes details of training attended and certificates. Supervision is in place. Currently the manager supervises all staff and is aiming to ensure that sessions are held on a monthly. The process is structured, planned and confidential. Records are maintained. A programme of individual performance review or appraisal is not yet in place. This is thought to be a consequence of the vacancy at home manager level which existed until the present manager took up post. The manager intends to re-establish appraisal within the next year. Porthcawl Green (52) DS0000030990.V346775.R01.S.doc Version 5.2 Page 23 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. This judgement has been made using available evidence including a visit to this service. A manager has recently been appointed and is reviewing systems within the home with the aim of achieving greater levels of consistency in the provision of the service to service users and other stakeholders. Arrangements for health and safety are uneven and gaps in information could reflect weaknesses in systems and potential risk to service users. EVIDENCE: The new manager had been in post for about four months. The manager is experienced in managing residential care services for vulnerable adults. The new manager is to start the NVQ 4 and Registered Manager’s Award (RMA) in January 2008. The manager is not yet registered with CSCI. Porthcawl Green (52) DS0000030990.V346775.R01.S.doc Version 5.2 Page 24 The manager has begun making changes in the home – in the layout of its accommodation and its administrative systems – and had recently attended management training in West Sussex on new processes for risk assessment and management. Further events are planned and are likely to influence change within the service in 2008. Service users are involved in the running of the home through house meetings and in their day-to-day interactions with staff. The new manager seeks to obtain the views of other stakeholders – such as care managers – as she meets them. A formal stakeholder survey has not been carried since the last inspection. The arrangements for health and safety appeared unclear. There is a health and safety policy in place. The manager is accountable to the area manager who carries out Regulation26 visits to the home on behalf of the organisation. These include a review of the health and safety aspects of the home. Within the home one member of staff has a lead responsibility for health and safety. A comprehensive file is held in the office and detailed health and safety checklist of the environment is completed each month. Up to date information on some aspects of health and safety procedures was not readily available at the time of the inspection visit. According to records the most recent fire training and fire drill appeared to have taken place in August 2006. Arrangements are in place for the maintenance of fire safety equipment. Some equipment had been checked in June 2007. The alarm points had been checked in November 2007. The emergency lighting had been checked by contractors in January 2007. The most recent fire risk assessment appeared to have been carried out in October 2006. Information on the date of the most recent check on portable electrical appliances (‘PAT testing’), the home’s fixed wiring and a check on gas systems by a CORGI engineer was not available. Staff are trained in moving and handling. Systems are in place for recording accidents. Personal risk assessments are in service users files. COSHH data sheets are available in the office. Porthcawl Green (52) DS0000030990.V346775.R01.S.doc Version 5.2 Page 25 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 X 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 2 23 2 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 1 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 2 X 2 X X 2 X Porthcawl Green (52) DS0000030990.V346775.R01.S.doc Version 5.2 Page 26 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 YA34 Regulation Schedule 2 Requirement The manager must ensure that staff records contain the information required under Schedule 2 (of Regulation 7, 9 and 19) The manager must establish systems for reviewing and improving the quality of care provided. The manager must ensure that appropriate records of health and safety procedures are maintained. Timescale for action 31/12/07 2 YA39 24 28/02/08 3 YA42 13 (4) 31/12/07 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 YA22 YA23 Good Practice Recommendations The manager should ensure that the home’s complaints procedures have been adapted for local use and are in a form appropriate to the needs of service users. The manager must obtain a copy of the local statutory organisations multi-agency policy on safeguarding vulnerable adults and make this available to staff and DS0000030990.V346775.R01.S.doc Version 5.2 Page 27 Porthcawl Green (52) service users. Porthcawl Green (52) DS0000030990.V346775.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Oxford Area Office Burgner House 4630 Kingsgate, Cascade Way 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. 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