Inspection on 09/08/07 for 6 Durlands Road

This inspection was carried out on 9th August 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

6 Durlands Road 12/10/06

6 Durlands Road 29/09/05

6 Durlands Road 18/04/05

6 Durlands Road 25/10/04

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 6 Durlands Road Horndean Waterlooville Hampshire PO8 9NT Lead Inspector Tracey Horne Unannounced Inspection 9th August 2007 09:00 6 Durlands Road DS0000060861.V342913.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 6 Durlands Road DS0000060861.V342913.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. 6 Durlands Road DS0000060861.V342913.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 6 Durlands Road Address Horndean Waterlooville Hampshire PO8 9NT 023 9259 1915 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) Robinia Care Group Ltd Position vacant Care Home 4 Category(ies) of Learning disability (4) registration, with number of places 6 Durlands Road DS0000060861.V342913.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th October 2006 Brief Description of the Service: 6 Durlands Road is a large, detached care home providing personal care, accommodation and support for four young adults with learning disabilities and complex needs. The home was opened in August 2004 and is set in a residential area on the outskirts of Horndean, on the A3 between Guildford and Portsmouth. The home is one of many owned and run by Robinia Care, a national company based in the South of England. The fees range from £1,540.00 - £2,571.00 per week. 6 Durlands Road DS0000060861.V342913.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The purpose of the inspection was to assess how well the home is doing in meeting the key National Minimum Standards (NMS) and Regulations. The findings of this report are based on several different sources of evidence. These included: an unannounced visit to the home, which was carried out on the 9th August 2007 between 09.00 and 14.30, during which Mrs Tracey Horne, Inspector had the opportunity to speak to service users and staff, look at records and observe interaction between people living and working at the home. The people living in the home prefer to be referred to as service users, therefore the rest of this report will reflect this. We received an Annual Quality Assurance Assessment (AQAA) prior to this visit, which provided further evidence of how the service is meeting the Key National Minimum Standards. The Commission for Social Care Inspection (CSCI) sent feedback forms to the home prior to this site visit. One resident, a member of staff and one healthcare professional completed and returned their surveys to the CSCI prior to this visit, as did two relatives. All regulatory activity since the last inspection was reviewed and taken into account including notifications sent to the CSCI. Miss Emma Hayles is applying to the CSCI to be registered manager of the home. What the service does well: What has improved since the last inspection? Service users’ money, passports, birth certificates and lighter fluid is stored in a safe, secure place. A new carpet has been fitted to the stairs. 6 Durlands Road DS0000060861.V342913.R01.S.doc Version 5.2 Page 6 All Health and Safety policies have been updated by the Health and Safety Executive. Two members of staff provide waking cover each night. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. 6 Durlands Road DS0000060861.V342913.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection 6 Durlands Road DS0000060861.V342913.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. 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. A procedure for assessing the needs and aspirations of potential new service users is in place to ensure the service users and the homes needs are met prior to admission. EVIDENCE: The AQAA states that a full assessment of the service users needs ensures that the needs can be met within the home. Prospective service users are provided with our homes statement of purpose that is available in a suitable format. Service user files showed that each service user had an assessment of need prior to moving into the home. The assessments had been completed with input from service users, where possible, and input from families. Assessments were written clearly and covered the range of different need areas. Miss Hayles confirmed that all of the service users living at the home have done so since it was opened in 2004. 6 Durlands Road DS0000060861.V342913.R01.S.doc Version 5.2 Page 9 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 & 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users’ individual plans reflect their assessed and changing needs and personal goals. Practices within the home demonstrate that service users are encouraged to make decisions about their lives and to take risks as part of an independent lifestyle EVIDENCE: The AQAA states that care plans have been developed according to assessments with service user and family involvement, to create individual and supportive care plans for each aspect of a service users life. Care plans have been made pictorial so that the service users can understand. Risk assessments are developed in a positive way to enable service users to carry out activities of their choice. Service users are supported to make informed decisions in there lives. One member of staff stated the home is very person centred and all service users are supported as they need. 6 Durlands Road DS0000060861.V342913.R01.S.doc Version 5.2 Page 10 Two relatives stated ‘Care is given as my relative would expect.’ ‘The majority of the time the care my relative receives is of high standard. The staff are caring of his needs and do their best to meet this as best they can.’ One healthcare professional (representing a team of professionals) stated ‘The care service sometimes responds to the different needs of individuals, the staff show little understanding of specific characteristics and needs’. Training records were seen and showed that training in specific areas is needed, therefore a requirement was made. The inspector looked at three care plans, all been developed and reviewed in a person centred way. Information such as people who are important to the individual and places of interest, likes and dislikes and dreams and aspirations. Records showed progress made towards achieving goals and aspirations, one resident is being supported to learn how to lock and unlock his bedroom door with his own set of keys. Some of the daily records seen had been written inappropriately for the service user group, for example one entry stated ‘..has been mouthy towards staff.’ This was brought to Miss Hayles attention, who agreed training in report writing and use of appropriate language would be beneficial for some staff. Guidelines are in place for ‘talk time’ (which enables service users to discuss their feelings, identify their mood and discuss any concerns) and for deep breathing exercises to aid relaxation, which in turn has been found to minimise anxieties which could lead to challenging behaviours. Service users, or their representatives have agreed to intervention by trained staff if behaviours put service users, staff or visitors at risk. Through observation it was evident that service users are able to make decisions about their lives. Service users said they are able to choose how they spend their time, when they get up, go to bed and when they want to eat and which member of staff they prefer to be their keyworker. One service user stated ‘Staff knock my door and ask when I would like personal care.’ One service user has expressed a wish to move from the home (Notice expires 15th August 2007). The home have been supporting him through this transition by developing a ‘when I leave Durlands’ book. One member of staff (under the guidance of a psychologist) has worked with the service user to explore how he may be, and will feel as he moves from his home and friends of three years. The book includes ways in which he can keep in touch. One service user has a similar book which helps him identify how he may feel when his friend leaves. All service users have a similar book for ‘what to do in a fire.’ 6 Durlands Road DS0000060861.V342913.R01.S.doc Version 5.2 Page 11 Risk assessments seen were drawn up on an individual basis and the emphasis on independence and positive outcomes supports service users to achieve their goals and aspirations. There were risk assessments in place for outings and holidays that service users had been on, which were no longer relevant. Miss Hayles said that she is in the process of reviewing all risk assessments to ensure they are accurate. 6 Durlands Road DS0000060861.V342913.R01.S.doc Version 5.2 Page 12 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): 12,13,15,16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users feel able to make choices about their life style, and are supported to develop their life skills. Social, cultural and recreational activities meet individual’s expectations. Service users enjoy their meals and receive a well balanced and varied diet. EVIDENCE: The AQAA states that service users have the opportunitys to take part in valued and fulfilling activities of their choice. These include leisure, education and and supported employment. Service users are out in the community regularily, undertaking activities of their choice. Friends and families feel welcomed and visit regularly. Service users are encouraged to have goals and objectives. these range from making their own bed to preparing their own supper at night. This encourages the service users to gain more independence. 6 Durlands Road DS0000060861.V342913.R01.S.doc Version 5.2 Page 13 Providing service users with a choice for developing menus, offering guidance on a healthy varied diet. This is done through picture format for a better understanding. Service users are supported to do the home’s weekly food shopping, prepare and make their own meals and snacks thus giving more choice and independence. They have been supported to learn how to unlock the kitchen with the key,(this restriction is in place to safeguard health and welfare of one service user). One service user survey stated ‘good support for clients needs in the community and at home.’ Two relatives stated ‘Staff are good at choosing activities for my relative who has limited communication, and arranging appropriate holidays.’ ‘My relative has a very fulfilling timetable thanks to the care staff choosing activities which they know will meet his needs.’ Staff suggested going out for a picnic lunch, as it was a nice day, all service users agreed and helped staff prepare the lunch. Records showed a variety of outings have taken place, as individuals and as groups. Such as Options and the Grove day services, college, rambling, trampoline, gym and days out to theme parks. Most of the activities coincide with service users goals and ambitions. Staff said that activities tend to be arranged as a group at weekends because of staff numbers and availability of staff to drive the homes vehicle. Miss Hayles said that recent changes in staff and clearer guidelines for staff and service users (why it is important to wear a seatbelt, for example) have reduced incidents occurring whilst service users have been out together. Service users are encouraged to maintain relationships that are important to them, one resident said he visits his family regularly, and the visitors’ book showed names of family, friends and care managers. Staff confirmed relatives are invited to attend annual reviews so they could be involved in care planning if the resident wants. A Bar-B-Q has been organised for a few weeks time for families and friends to attend. Service users said staff support them to take responsibility for household tasks, this forms part of the daily activities and work to achieving personal goals. Healthy meals are provided and service users said they enjoyed helping with the planning of menus, cooking, liked the food and meal times are flexible to fit around their activities. The menu for the day was displayed in the dining room in picture format. Service users said they felt that staff understood them and listened to their views and opinions. This was also evident through discussion with staff who were allocated as the resident’s key worker. 6 Durlands Road DS0000060861.V342913.R01.S.doc Version 5.2 Page 14 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. Service users receive health & personal care on an individual basis. The home practices the principles of respect, dignity and privacy. EVIDENCE: The AQAA states that service users regually attend their health appointments and have an annual medical at Head Office by the company doctor. Records seen confirmed this and one healthcare professional stated that service usres healthcare needs are usually met. Staff follow care plans and encourage the service users to choose when they would like to be supported with personal care. Service users are encouraged to be as independent in this as possible within their personal care which is provided in their en-suite bathroom or in a bathroom where they will not be disturbed. Service users choose to the best of their ability their clothes and hairstyle they would like. Service users have regualar input from Community Learning Duisability Team (CLDT), Elipesy clinic, GPs, Speech and Language Therapists, Pschologist and Nurses. 6 Durlands Road DS0000060861.V342913.R01.S.doc Version 5.2 Page 15 Service users and their relatives stated that personal and healthcare support is provided as the individual wishes. Staff spoken with were clear about each person’s individual preferences as they had worked with the service users for some time, know them well and said service users are able to communicate their wishes with them. Care plans seen confirmed this. Miss Hayles said that the high level of staff support is needed to provide adequate support for individual service users, and that staff respect peoples privacy. One service user said he can go to his bedroom for privacy if he wants to. Care plans were clear and included details of individual’s visits to healthcare professionals, such as the doctor, optician, speech therapist and dentist. Each care plan had a health action plan. One service user stated ‘Staff knock my door and ask when I would like personal care.’ One relative stated care staff usually have the right skills and experience to look after my relative. A healthcare professional stated that referrals have been made for support with specific training and for advice regarding guidelines from the psychologist, but the advice given has not been followed consistently, which has resulted in unpleasant incidents occurring within the home and community. Mrs Hayles acknowledged this and said that changes have been made to the staff team and specialist training will be sought to meet the diverse needs of service users. The home has an arrangement with the local pharmacist for medication to be supplied in a monitored dosage system. Individual’s medication, together with any creams and lotions are stored securely. One resident confirmed they prefer staff to administer their medication. The medication administration record (MAR) had been completed for the morning’s medication. One member of staff said that they had received training in the safe administration of medication, training certificates confirmed this. 6 Durlands Road DS0000060861.V342913.R01.S.doc Version 5.2 Page 16 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. Service users feel able to air their views and make complaints. The policies and procedures used in the home, and the training staff have received protect service users from the risk of abuse EVIDENCE: The AQAA states two complaints and two Safeguarding Adult Protection referrals have been made and were dealt with appropriately. The complaints policy and procedure is displayed in the homes office and the procedure is regually discussed with service users. The complaints log includes details of all complaints, invstigations, actions taken and any outcomes. This is regually checked. Regular service user meetings are held to gain the views from people living in the service. The complaints procedure is in a format suitable for service users. The complaints log was seen to include details of the date when a complaint was made, the date action was taken, by whom and the outcome. The details of one complaint received was included, Miss Hayles said that the other complaint was being dealt with by head office. Miss Hayles agreed to obtain copies of the paperwork relating to the complaint for the home’s records. 6 Durlands Road DS0000060861.V342913.R01.S.doc Version 5.2 Page 17 All service users are offered daily 1.1 time with different staff whom they choose and are made aware they can raise any concerns. Staff are trained in dealing with abuse. Robinia has strict policies and procedures on this subject in appliance to No Secrets Act and guidelines of how to report any suspected abuse. The valuing people document is made available to all staff and is kept in the homes office. Robinia has a whistle blowing policy that all staff are made aware of. Staff, relatives and a healthcare professional confirmed they were aware of the home’s complaints procedure. One relative has raised concerns in the past, action was taken to alleviate concerns and strategies put in place. Records showed that Protection Of Vulnerable Adult (POVA) check and enhanced Criminal Records Bureau (CRB) disclosure had been completed prior to commencing post, and the home update CRB’s every two years. During the visit service users spoke openly with staff about any questions or concerns they had, staff were quick to respond, and explained most of the time service users need reassure about what is happening during the day. Staff acting promptly and consistently elevated any anxieties. Staff are trained and are aware that physical intervention is only to be used as a last resort and only interventions that are stated in the care plans are used. Any intervention used is documented in the physical intervention book. Each service user has a risk assessment for handling their finances. Staff support service users to control their finances in accordance to policy and procedure. Miss Hayles regularly carries out an audit of resident’s financial affairs. Records showed that the home have acted appropriately regarding safeguarding adults procedures, and have recently made improvements to security, record keeping and by reviewing the staff team which had been highlighted as concerns by Social Services. Records seen confirmed that staff have attended training regarding adult protection issues. 6 Durlands Road DS0000060861.V342913.R01.S.doc Version 5.2 Page 18 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 & 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The physical design and layout of the home enables people who use the service to live in a comfortable environment, which encourages independence. Service users would benefit from some areas of the home being refurbished. EVIDENCE: The AQAA states that the home is clean and tidy throughout but maintains a homeliness and comfort. The home is regularly maintained. The gardens and conservatory areas of the home are accessible to service users and are nicely kept. Service users help to manintain a vegetable garden. The home also has a sensory room, which service users use for relaxation purposes. Three of the rooms have en-suite facilities and the other room has his own bathroom just outside his room. All service users are provided with a bedroom with fixtures and fittings suitable to their needs and are encouraged to decorate their rooms to their choice. 6 Durlands Road DS0000060861.V342913.R01.S.doc Version 5.2 Page 19 The home has infection control procedures in place and staff are aware of these. There are handwashing facilties avaliable in every bathroom and kitchen. Soap and Hand Sanitiser is provided. We have a separate laundry room where the floors and walls are cleanable, a pictorial guide is used to show what temperatures to wash laundry at. The windows of communal areas can only be opened if staff are present but there is a portable air conditioning unit in the lounge. The kitchen door is risk assessed to be kept locked, although staff are supporting some service users to use their own key to access this area. Service users tend to spend the majority of the time whilst in the home in their bedrooms or with staff in communal areas. One relative stated ‘The home has been looking less of a home for clients, the dining room furniture piled in the conservatory, broken items are not adequately replaced and the home appears sparse as there are very few personal items in communal areas, doors are continually locked.’ The conservatory is used for furniture storage and this is to safeguard service users, as some behaviours include throwing furniture. This situation is being reviewed. Service users have personalised their bedrooms with pictures, posters and entertainment systems, but the communal areas are quite sparse. There used to be a large television in the lounge, which was broken and has been replaced by a member of staff’s portable television. Miss Hayles said that she has requested permission to buy a new television. The lounge carpet has an iron shaped burn mark on it and is stained. The dining room tables and chairs are rickety and shabby, and there aren’t enough chairs for staff to join service users to eat, they perch on the windowsills. The dining room walls are chipped in some areas. A requirement was made. In the bathroom a rubber bath mat was removed, as it was old and discoloured, as was the shower certain. Miss Hayles said that the shower curtain is not used because the service user prefers a bath, so it will be removed. The garden is enclosed and service users enjoy using the large paddling pool in warm weather. Miss Hayles said that maintenance requests are sent via email to head office each Monday (unless it’s urgent) and the jobs are actioned two days later (unless urgent) Staff said that the system has improved the time it takes for items to be fixed. 6 Durlands Road DS0000060861.V342913.R01.S.doc Version 5.2 Page 20 One staff stated that the home is always clean and fresh, there is a cleaning rota that happens every day.’ Certificates confirmed that staff have received training in the prevention of infection & management of Infection Control and were aware of the home’s policies and procedures of hygiene issues. 6 Durlands Road DS0000060861.V342913.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, 34 & 35. Quality in this outcome area is Adequate. This judgement has been made using available evidence including a visit to this service. Improvements are needed to ensure Service users are supported by staff that are trained, skilled and in sufficient numbers. Service users are protected by the home’s recruitment practices. EVIDENCE: The AQAA states that staff are trained in epliepsy, autism, first aid, equal opportunities, values and standards to ensure service users are treated with dignity and respect, communication, manual handling and many other compulsory courses. One member of staff who has completed her National Vocational Qualification (NVQ) level 4, three with NVQ 3, another two working towards their NVQ 3 and another member of staff with their NVQ 2 in Health and Social Care. All staff have regualar supervions (at least 6 per year) and are encouraged to identify and training and work issues. Staff are given annual appraisals where goals and objectives are reviewed and set, these are currently only carried out by the home manager and team leader whom have received supervision and appraisal training. 6 Durlands Road DS0000060861.V342913.R01.S.doc Version 5.2 Page 22 As part of induction, staff are given job descriptions and these are checked they are understood in supervision. Staff are also required to undertake the Certificate In Working With People With A Learning Disability, to give them the skills and experience needed for the tasks they are required to do. Staff are all made aware of policies and procedures and the homes statement of purpose. The staff must sign to say they have read these and questions are asked during supervision to ensure they are understood. Staff are required to read all risk assesments. The main recruitment process is carried out through the human resources department. The home manager interviews the staff. Two refernces and an enhanced disclosure and POVA check must be obtained. Staff are given copies of the General Social Care Council (GSCC) codes of conducts. After the core training staff are given indivudaual training and development plans within supervisions and appraisals. New staff are given a six month Probation period. Relatives and healthcare professionals stated that the skill of some staff seems to vary, as does the knowledge and awareness of the complex needs individuals have. Miss Hayles said that the home are currently recruiting new staff, who are experienced. A requirement was made to ensure staff receive training to meet individual’s needs. We found that during the inspection staff were confident and competent, were clear about their roles and responsibilities and are confident Miss Hayles will provide clear leadership. The recent changes to staffing have improved how the staff team work together, something they felt has been lacking. They said they enjoyed their work and spoke about service users in a sensitive and positive manner and were seen interacting in this way. The staff undertake the cooking and cleaning with the service users assisting where possible, one resident was helping staff prepare the lunch, which they said they enjoyed. No separate ancillary staff are employed at the home. Staff said that generally there are enough staff on duty, a problem may occur if all service users want to do different activities at the weekends, but this rarely happens, if it does a compromise is sought. Two members of staff provide waking cover each night, something that has been introduced recently and staff said is an improvement. 6 Durlands Road DS0000060861.V342913.R01.S.doc Version 5.2 Page 23 Miss Hayles said that the home has recently recruited three male staff and interviews are taking place on the 20th august for the remaining nineteen hours (in total) vacancies. Miss Hayles said that the applicants are of various ages that would benefit service users and staff. Currently the home are using agency staff to cover the vacancies, but Miss Hayles said they use the same agency for continuity of staff. Staff training incorporates Common Induction Standards, in line with national guidelines for good practice that include elements relating to values, individuality and learning disability. Two files of recently employed staff were seen and showed that all relevant pre employment checks had been carried out. Staff spoke enthusiastically about the training they receive and felt it enables them to do their job. But training records showed that updated training was overdue in most cases. Miss Hayles provided evidence that training had been requested in May 2007, but nothing has been arranged, therefore a requirement was made for training to be provided to all staff who need it. Miss Hayles said she is arranging for intervention training to be more specific to meet individual service users and staff need. 6 Durlands Road DS0000060861.V342913.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 good This judgement has been made using available evidence including a visit to this service. Service users benefit from improvements that have been made to the staffing structure, that ensures they are living in a well run home. Service users views are fully considered within the home’s quality assurance processes and are protected by the home’s Health and Safety policies and practices. EVIDENCE: The AQAA states that the home manager has seven years experience of working with people with a learning disability and four years in a supervisory position. Miss Hayles is currently working towards her NVQ 4 and Registered Managers Award (RMA). The home manager devises a weekly report that is sent to head office to ensure budgets are being met and has a monthly budget meeting. 6 Durlands Road DS0000060861.V342913.R01.S.doc Version 5.2 Page 25 Senior managers visit the home regularily, questionnaires for service users, families and other professionals, input from service user meetings as well as individual service user input through the care planning process and through daily activities, behaviour and discussions all form part of our quality assurance. Finance audits ensure the management of the home is meeting standards. All staff has received health and safety training and workplace risk assessments were in place and are regularly reviewed. Records are kept to show that all equipment is regularly serviced. All accident and incident records are clear and Miss Hayles regularly monitors and reviews these in order to look for patterns and plan to decrease future occurrence of these. One member of staff said ‘My manager and deputy are always willing to support me if needed, I can always speak to higher management.’ Miss Hayles has started the process of applying to the CSCI to be come the registered manager and has completed her NVQ 4. The systems in place, and staff approach demonstrated that the home was managed for the benefit of service users. The home have regular monthly visits from senior managers to carry out un announced Regulation 26 visits, provide questionnaires for service users, families and other professionals, hold service user meeting as well as individual service user input through the care planning process and through daily activities, and staff meetings, supervisions and appraisals. Records were kept to show that all equipment was regularly serviced. All accident and incident records were clear and Miss Hayles regularly monitored and reviewed these in order to look for patterns. As mentioned earlier in the report, staff would benefit from training in health and safety issues. 6 Durlands Road DS0000060861.V342913.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 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 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 2 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 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 X 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X 6 Durlands Road DS0000060861.V342913.R01.S.doc Version 5.2 Page 27 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA24 Regulation 23.2 (c,d,g) 18.1(ci) Requirement Timescale for action 20/09/07 2 YA35 The provider must ensure all parts of the home are reasonably decorated and that all dining furniture is safe. 20/09/07 The provider must ensure all staff have received the following mandatory training: moving and handling, health and safety, first aid, infection control, food hygiene, abuse and fire safety and specialist training in recognising and managing sexual behaviour, intervention techniques specific individual’s needs, epilepsy and record keeping. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations 6 Durlands Road DS0000060861.V342913.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 6 Durlands Road DS0000060861.V342913.R01.S.doc Version 5.2 Page 29 - 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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